Graft-vs-host disease and immunologic reconstitution in bone marrow transplant recipients of related and unrelated grafts using total T-cell depletion (Meeting abstract).

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Graft-vs-host disease and immunologic reconstitution in bone marrow transplant recipients of related and unrelated grafts using total T-cell depletion (Meeting abstract).

Exp Hematol; 20(6):707 1992. Unique Identifier : AIDSLINE ICDB/93688142
Hedderman A; Tricot G; Ballas CB; Leemhuis T; Grigsby S; Graves V; Hoffman R; Lebkowski J; Srour EF; Indiana Univ. Sch. of Medicine, Indianapolis, IN

Abstract: Graft-vs-host disease (GVHD) and immunologic reconstitution in 38 patients (pts) transplanted for different hematopoietic malignancies with allogenic-matched (n=28) or -mismatched (n=10), related (n=18) or -unrelated (n=20) T-cell-depleted bone marrow (BM) grafts were examined. BM grafts were T-cell-depleted using soybean agglutination and selection over CD5- and CD8-coated CELLector devices. GVHD was confirmed in 18 pts, 9 of whom received mismatched grafts. The efficacy of T-cell depletion (2.101 +/0.55 log; mean +/- SD), the number of CD3+ cells infused (0.05-39.8 x 10(5)/kg; median = 0.42 x 10(5)/kg) or whether the MLC was reactive or not (13/18 pts with GVHD had a reactive MLG) did not correlate with GVHD. However, logistic regression indicated that the percentage of residual CD8+ cells (including CD8+ NK cells) in the graft was a significant predictor of GVHD (p=0.02). Upon further analysis, the CD3+, CD8+ and the CD8+ NK fractions of the residual CD8+ cells predicted GVHD at the 0.015 and 0.14 levels, respectively. In PB of pts receiving related and unrelated grafts CD16/56+ and CD3+ cells were detected as early as days 14 and 21 after transplantation, respectively. In related pts, a normal CD4/CD8 ratio was after day 80. T-cell reconstitution and reestablishment of normal CD4/CD8 ratio in pts receiving unrelated grafts was slower than that in recipients of related grafts. These data suggest that the kinetics of immunologic reconstitution in pts receiving related or unrelated BM grafts are different and that there is a correlation between GVHD and residual CD8+ cells (in general) or CD3+ cells (in particular) in the graft.

Keywords: Antigens, CD/ANALYSIS Antigens, CD3/ANALYSIS Antigens, Differentiation, T-Lymphocyte/ANALYSIS *Bone Marrow Transplantation CD4-CD8 Ratio Graft vs Host Disease/*IMMUNOLOGY/THERAPY Human *Leukocyte Count Lymphocyte Depletion Receptors, IgG/ANALYSIS *T-Lymphocytes T-Lymphocytes, Suppressor-Effector ABSTRACT
930330
M9331093

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