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Early infusion of donor T cells prevents graft versus host disease in blood cancer patients
Date:2/3/2011

this study, which enrolled 22 patients with acute myeloid leukemia (AML), five patients with acute lymphoid leukemia (ALL), and one patient with high-grade non-Hodgkin lymphoma. Four days before HSCT, the 28 patients were infused with donor Tregs, and on the day of the transplant, they were infused with normal T cells in an effort to simultaneously prevent GVHD and promote immune system recovery.

"Our aim was to determine if patient outcomes could be improved if Tregs were introduced early in the transplantation process," said senior study author Massimo F. Martelli, MD, Full Professor and Head of the Umbria Region Bone Marrow Transplantation Program at the University of Perugia.

Results of the study revealed that 26 patients achieved full-donor engraftment, meaning that all of the transplanted donor cells were able to reproduce into new, cancer-free cells. Only two of the 26 patients that were evaluated developed acute GVHD, and at median follow-up of 11.2 months none of the patients had developed chronic GVHD. The immune system of these patients was restored to normal levels, better than other patients who had not received the T cell infusions. There were also fewer episodes of the reactivation of Cytomegalovirus (CMV), a common virus known as a major cause of morbidity and mortality after HSCT due to a weakened immune system, and no patient developed CMV disease. Furthermore, early Treg infusion was not associated with an increased incidence of leukemia relapse; only one relapse had occurred at median follow-up of 12 months in a patient with AML. One patient died from adenoviral infection and GVHD and one died from GVHD; at median follow-up of 12 months, 12 patients (46.1 percent) were alive and disease-free.

"This is an update of the first study in humans that demonstrates that regulatory T cell-based therapy ensures that hematopoietic stem cell transplant is successful, without triggering GVHD, by reconstituting the patient's immun
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Contact: Lindsey Love
webmaster@hematology.org
202-552-4925
American Society of Hematology
Source:Eurekalert

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