PMID: 9531622May 16, 1998Paper

Risks of developing Epstein-Barr virus-related lymphoproliferative disorders after T-cell-depleted marrow transplants. CAMPATH Users.

Blood
G Hale, H Waldmann

Abstract

T-cell depletion of bone marrow for allogeneic transplantation is known to increase the risks of Epstein-Barr virus-driven lymphoproliferative disorders that may result in fatal lymphoma, especially with transplants from unrelated or mismatched donors. Over the past 15 years, we have monitored the outcome of 2,582 transplants using CAMPATH-1 (CD52) antibodies to deplete lymphocytes from donor and/or recipient to prevent graft-versus-host disease or rejection. Unlike many other methods of T-cell depletion, CAMPATH-1 antibodies also deplete B lymphocytes. The actuarial risk of lymphoproliferative disease using CAMPATH-1 for depletion of donor lymphocytes was up to 1.3%, hardly different from reported figures for conventional nondepleted transplants. In contrast, the risk in a small group of patients transplanted from unrelated donors using E-rosette depletion was as high as 29%, comparable to other reports of specific T-cell depletion. We conclude that the additional depletion of B cells is beneficial, possibly because it reduces either the virus load or the virus target until the time when T cells begin to regenerate.

Related Concepts

Related Feeds

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.