T-cell depletion of allogeneic peripheral blood stem cells

Baillieres Best Pract Res Clin Haematol. 1999 Mar-Jun;12(1-2):87-98. doi: 10.1053/beha.1999.0009.

Abstract

The high content of immunocompetent T-cells in apheresis products may expose recipients of allogeneic peripheral blood stem cells (PBSC) to an elevated risk of acute and chronic graft-versus-host disease (GvHD). Thus, the use of an appropriate T-cell reduction or depletion technique might reduce this risk. The hazards of rejection and of a higher relapse rate should be avoided by maintaining a portion of the T-cells in the graft or by increasing the number of transplanted stem cells. The positive selection of CD34+ cells from peripheral blood preparations simultaneously provides an approximately 1,000-fold reduction of T-cells. Purified CD34+ cells containing committed and pluripotent stem cells are suitable for allogeneic transplantation. In transplantation from HLA-mismatched or three HLA-loci different family donors the amount of stem cells can be increased for reducing the incidence of rejection without increasing the T-cell number. In cases of poor marrow graft function a 'boost' with stem cells from the same family donor can be given. The risk of GvHD in transplantation from volunteer-matched unrelated donors might be reduced by T-cell depletion. If T-cells are used for enhancing the graft-versus-leukaemia effect, CD34+ enriched cells can be given for haematopoietic engraftment.

Publication types

  • Review

MeSH terms

  • Antigens, CD34 / blood
  • Cell Separation / adverse effects
  • Cell Separation / methods*
  • Cell Separation / standards
  • Graft vs Host Disease / prevention & control
  • Hematopoietic Stem Cells / cytology*
  • Hematopoietic Stem Cells / immunology
  • Humans
  • Lymphocyte Depletion / statistics & numerical data*
  • T-Lymphocytes*
  • Transplantation, Homologous / adverse effects
  • Transplantation, Homologous / methods
  • Transplantation, Homologous / standards

Substances

  • Antigens, CD34