asta-z-7557 and Graft-vs-Host-Disease

Topics: Adolescent; Adult; Animals; Bleomycin; Bone Marrow; Bone Marrow Transplantation; Cell Separation; Child; Child, Preschool; Clinical Trials as Topic; Cyclophosphamide; Drug Evaluation; Etoposide; Graft vs Host Disease; Hematopoietic Stem Cells; Humans; Leukemia; Leukemia, Lymphoid; Lymphoma; Lysophosphatidylcholines; Methylprednisolone; Neoplasms, Experimental; Phospholipid Ethers; Pyrimidinones; Transplantation, Autologous; Transplantation, Isogeneic

Topics: Adolescent; Adult; Animals; Bleomycin; Bone Marrow; Bone Marrow Transplantation; Cell Separation; Child; Child, Preschool; Clinical Trials as Topic; Cyclophosphamide; Drug Evaluation; Etoposide; Graft vs Host Disease; Hematopoietic Stem Cells; Humans; Leukemia; Leukemia, Lymphoid; Lymphoma; Lysophosphatidylcholines; Methylprednisolone; Neoplasms, Experimental; Phospholipid Ethers; Pyrimidinones; Transplantation, Autologous; Transplantation, Isogeneic

Ex vivo bone marrow treatment prior to autologous bone marrow transplantation for acute leukemia or solid tumors (known for their frequent medullary metastatic dissemination) has provoked a great deal of hope and enthusiasm. If, as in most cases, the feasibility of various methods (exposure to chemical products, monoclonal antibodies and complement-dependent cytolysis, immuno-magnetic procedures) has been confirmed, no study to date has shown the efficacy. Only randomized studies will result in such a proof, on the condition that all the specific technical parameters of each method have been perfectly defined. The clinical results of pilot evaluation studies for the prevention of graft-versus-host reaction through the elimination of T lymphocytes in the donor graft have been encouraging. They have shown the feasibility and efficacy of different methods of T cell depletion. One point however remains controversial: is it necessary or not to eliminate all T lymphocytes? After a depletion which is too efficient, the difficulties involved in grafting the donor's hematopoietic cells on the recipient represent a new problem, e.g., in allogenic grafts for acute leukemia (host-versus-graft). In order to resolve the problem of these take failures (10 to 20% of the published series except for Royal Free Hospital and Besançon) it appears necessary to redefine the conditioning regimen prior to allogenic bone marrow transplantation.

Topics: Antibodies, Monoclonal; Antigens, Neoplasm; Bone Marrow; Bone Marrow Cells; Bone Marrow Transplantation; Cell Separation; Centrifugation, Density Gradient; Cyclophosphamide; Graft vs Host Disease; Humans; Lectins; Leukemia; Lymphocyte Depletion; Methylprednisolone; Neoplasms; Neprilysin; Pilot Projects; Plant Lectins; Ricin; Soybean Proteins; T-Lymphocytes; Transplantation, Autologous; Transplantation, Homologous