This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. While stem cell transplantation has proven an effective means of treating a wide variety of diseases involving hematopoietic stem cells and their progeny, a shortage of donors has proved a major impediment to the widest application of the approach. Administration of donor lymphocytes selectively depleted of alloreactive T-cells that can cause graft-versus-host disease (GVHD) results in improved and enhanced immune function reconstitution and decreased disease relapse without causing severe GVHD in patients after submyeloablative haploidentical stem cell transplantation. Haploidentical stem cell transplantation with a submyeloablative pretransplant conditioning regimen is thus a viable alternative therapy for patients without other suitable stem cell donors and concurrent illnesses making them ineligible for fully ablative transplants.
SPECIFIC AIMS :1)To determine the number of donor lymphocytes that can be given to patients with poor risk hematologic malignancies who received a haploidentical stem cell transplants after depletion of recipient-reactive T lymphocytes by ex-vivo treatment with a fixed dose of RFT5-dgA immunotoxin, and will result in a rate of Grade III/IV GVHD of <= 25%. 2)To analyze immune reconstitution in these patients. 3)To measure the overall and disease free survival at 100 days and at 1 year after haploidentical PBSCT.
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