BT13BTθ51 unrelated and partially matched related donor peripheral stem cell transplantation with α/β t cell and b cell depletion for patients with hematologic malignancies

Children’s Wisconsin is currently enrolling patients with hematologic cancers on a Pilot trial, coupling bone marrow transplant with α/β (alpha/beta) T-cell depletion in patients with:

Leukemias and lymphomas including:

• Acute myeloid leukemia
• Acute lymphoblastic leukemia
• Chronic myelogenous leukemia
• Mixed lineage or biphenotypic acute leukemia
• Lymphoblastic lymphoma
• Burkitt’s lymphoma/leukemia
• Myelodysplasia

One of our blood and marrow transplant and early-phase research physicians, Dr. Julie Talano, is the co-primary investigator of this trial. Children’s is one of two sites in the country where this trial is available. We are participating in collaboration with Children’s Wisconsin of Philadelphia.

Allogeneic stem cell transplant is curative for many patients with leukemias in which chemotherapy has <20% chance of achieving long-term remission. However, only 25-30% of patients will have an HLA identical sibling donor. A well matched unrelated donor, or mismatched related donor may be considered for these patients. However, acute and chronic graft vs.host disease (GVHD) are significant risks for patients who receive these alternative donor transplants. To overcome the risk of GVHD, various methods of T-cell depletion have been developed.

T-cell depletion of unrelated and partially matched related (PMR) donors has been done for over 20 years at the Children’s and the Children’s Wisconsin of Philadelphia for patients who lack matched related donors. This has enabled us to transplant patients who do not have either a matched related or unrelated donor who represent more than half of patients who may benefit from an allogeneic transplant.

The technology used for T-cell depletion (TCD) has changed through the years. The technology of T- cell depletion has evolved from methods that remove all of the T-cells, to more precise methods. Newer methods have become available using magnet-activated cell sorting including, depletion of α/β T lymphocytes. In this method, γ/δ+ T cells are retained. Those cells have potential anti-infectious and anti-tumor properties and are not considered to cause GVHD.

Our blood and marrow transplant program is FACT (Foundation for the Accreditation of Cellular Therapy) accredited and has performed over 1,100 bone marrow transplants.