[Prevention of the graft-versus-host disease by T-cell depletion in allogenic bone marrow transplantation].

Depletion of T-cells in allogenic bone marrow transplants by means of immunological or immunophysical methods has proved highly successful in preventing acute and chronic graft-versus-host disease (GvH) (less than 10% GvH above grade II, as opposed to 41% in historical series). However, T-cell depletion has been found to induce resistance to engraftment in 10 to 20% of the cases, and it may increase the incidence of relapses. Secondary complications can be prevented either by using in vivo monoclonal antibodies specific to the radio-resistant cells of the host, or by reinforced conditioning with a dual purpose: eradication of the residual immunocompetent cells in the host, and greater activity against the imperceptible tumoral mass. If subjects at high risk of GvH could be detected by means of predictive tests currently under evaluation, T-cell depletion could be reserved to that category of patients.