Evolving strategies to address adverse transplant outcomes associated withT cell depletion

Graft-versus-host disease (GVHD) is the major complication of allogeneic bo ne marrow transplantation (BMT), The most effective strategy to reduce GVHD has been T cell depletion (TCD) of the donor marrow graft. Although TCD ha s reduced both the incidence and severity of GVHD, it has been associated w ith an increased rate of graft rejection and an impairment in immune recons titution after transplant. Relapse rates in selected hematologic malignanci es have also been higher after TCD allogeneic BMT, Over the past several ye ars, a number of clinical strategies have been developed in an effort to re duce adverse transplant outcomes associated with TCD, This review examines some of the strategies designed to promote alloengraftment, prevent relapse , and enhance immune reconstitution after TCD.