Prior to the introduction of T cell depletion graft-versus-host disease (GVHD) was the major
cause of transplant-related mortality. Why has the remarkable technical achievement of
efficient T cell depletion, which has virtually eliminated severe GVHD over the last few years,
failed to reduce mortality and increase disease-free survival? This review examines the
value of T cell depletion based on recent clinical experience. It surveys the directions that
are being pursued in an effort to solve the problems that have arisen and indicates how this …

T cell depletion reduces the incidence and severity of graft-versus-host disease (GVHD)
following bone marrow transplantation in man. Graft-versus-host disease of more than grade
2 severity is decreased from about 45% to about 10% in recipients of HLA-identical
transplants. However, T cell depletion also increases the frequency of graft failure and
leukemia relapse. Graft failure increases from about 1 to 10% following HLA-identical
transplants. In patients with acute leukemia in first remission or with chronic myelogenous …