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Effects of T-Cell Depletion on Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in AML Patients

1
Adult Leukemia Service, Massachusetts General Hospital, Boston, MA 02114, USA
2
Harvard Medical School, Boston, MA 02115, USA
3
Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
4
Weill Cornell Medical College, New York, NY 10065, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Celalettin Ustun
J. Clin. Med. 2015, 4(3), 488-503; https://doi.org/10.3390/jcm4030488
Received: 7 September 2014 / Revised: 19 January 2015 / Accepted: 19 January 2015 / Published: 19 March 2015
(This article belongs to the Special Issue AML in the Molecular Age: From Biology to Clinical Management)
Graft versus host disease (GVHD) remains one of the leading causes of morbidity and mortality associated with conventional allogeneic hematopoietic stem cell transplantation (HCT). The use of T-cell depletion significantly reduces this complication. Recent prospective and retrospective data suggest that, in patients with AML in first complete remission, CD34+ selected grafts afford overall and relapse-free survival comparable to those observed in recipients of conventional grafts, while significantly decreasing GVHD. In addition, CD34+ selected grafts allow older patients, and those with medical comorbidities or with only HLA-mismatched donors to successfully undergo transplantation. Prospective data are needed to further define which groups of patients with AML are most likely to benefit from CD34+ selected grafts. Here we review the history of T-cell depletion in AML, and techniques used. We then summarize the contemporary literature using CD34+ selection in recipients of matched or partially mismatched donors (7/8 or 8/8 HLA-matched), and provide a summary of the risks and benefits of using T-cell depletion. View Full-Text
Keywords: AML; CD34+ selection; T-cell depletion; graft-versus-host disease; hematopoietic stem cell transplantation AML; CD34+ selection; T-cell depletion; graft-versus-host disease; hematopoietic stem cell transplantation
MDPI and ACS Style

Hobbs, G.S.; Perales, M.-A. Effects of T-Cell Depletion on Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in AML Patients. J. Clin. Med. 2015, 4, 488-503.

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J. Clin. Med., EISSN 2077-0383, Published by MDPI AG
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