A 56-Year-Old, Previously Healthy Man Has Worsening Fatigue and Recurrent

A 56-year-old, previously healthy man has worsening fatigue and recurrent epistaxis.  Evaluation shows anemia, thrombocytopenia, and abnormal circulating leukocytes.  Bone marrow biopsy establishes a diagnosis of acute myeloid leukemia.  The patient is initially treated with induction chemotherapy, and an allogeneic hematopoietic stem cell transplant is recommended.  A nonrelated, HLA-matched donor is not found, so the patient's adult son volunteers to be the donor.  The plan is for the patient to receive conditioning chemotherapy and radiotherapy followed by bone marrow transplant.  Prior to transplant, a procedure is performed to deplete CD3⁺ cells in the marrow graft.  This pretransplant procedure would be most helpful in decreasing this patient's risk for which of the following?

A) Cytomegalovirus infection
B) Graft versus host disease
C) Immunoglobulin deficiency
D) Leukemia relapse
E) Lymphoproliferative disease

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