T-cell Depletion of HLA-Identical Transplants in Leukemia

We analyzed the effects of T-cell depletion on the outcome of HLA-identical sibling bone marrow transplants for leukemia by comparing 731 T-cell-depleted transplants with 2,480 non-T-cell-depleted transplants. T-cell depletion decreased acute graft-versus-host disease (GVHD) (relative risk [RR] 0.45; P < .Mol) and chronic GVHD (RR 0.56; P < .Mol). However, it increased graft failure (RR 9.29; P < .OOOl). Leukemia relapse also was increased. In first remission acute leukemia or chronic phase chronic myelogenous leukemia, leukemia relapse was 2.75 times more likely after T-celldepleted transplants (P < .OOOl). T-cell depletion increased the risk of treatment failure (RR 1.35; P < .0003) and decreased leukemia-free survival. We also studied controllable variables associated with outcome of T-cell-depleted trans