Hematopoietic cell transplantation (HCT) using T cell-depleted grafts can yield low rates of chronic graft-versus-host disease (GVHD) and relapse in patients with acute myelogenous leukemia (AML) in first remission (CR1), according to the results of Blood and Marrow Transplant Clinical Trials Network (BMT CTN) trial 0303. This phase 2 single-arm multi-center study studied outcomes of 44 patients with a median age of 48.5 years (range, 21-59) receiving ex vivo T cell-depleted allogeneic grafts from HLA-identical siblings. The incidence of acute GVHD grade II-IV was 22.7%, and the incidence of extensive chronic GVHD was 6.8% at 24 months. The relapse rate for patients in CR1 was 17.4% at 36 months. With a median follow-up of 34 months, disease-free survival (DFS) for all patients was 82% at 6 months, and DFS for patients in CR1 was 72.8% at 12 months and 58% at 36 months. The authors concluded that the low risk of both relapse and chronic GVHD makes this approach feasible for selected high-risk patients with AML in remission.
Devine SM, et al. Biol Blood Marrow Transplant