Journal
JOURNAL OF CLINICAL MEDICINE
Volume 4, Issue 3, Pages 488-503Publisher
MDPI
DOI: 10.3390/jcm4030488
Keywords
AML; CD34+ selection; T-cell depletion; graft-versus-host disease; hematopoietic stem cell transplantation
Categories
Funding
- National Cancer Institute [PO1 CA23766]
- American Society of Clinical Oncology Young Investigator Award
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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.
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