Back to Search
Start Over
Donor lymphocyte infusions (DLI) in patients with chronic myeloid leukemia following allogeneic bone marrow transplantation.
- Source :
-
Bone Marrow Transplantation . 5/1/97, Vol. 19 Issue 9, p927. 6p. - Publication Year :
- 1997
-
Abstract
- Donor lymphocyte infusions (DLI) were given between June 1990 and March 1996 to 18 patients with chronic myeloid leukemia (CML) for the treatment of cytogenetic (n = 6) or hematologic relapse (n = 12) following an allogeneic bone marrow transplant (BMT). Patients were divided in two groups: patients in group A (n = 8) received a large dose of donor lymphocytes (1 × 108/kg), whereas patients in group B (n = 10) received escalating numbers of cells (2 × 105 up to 2 × 108/kg). The median number of DLI in group A was 2 (range 1–3); the median number of infusions in group B was 7 (range 3–9). Acute GVHD occurred in 12 patients (grades I–III) and was a major cause of death in two. The risk of developing GVHD correlated with the number of cells infused: 37%, 14%, 5% and 0% for DLI with cells 1 × 108, 2 × 107/kg, 2 × 106/kg, and 2 × 105/kg, respectively (P = 0.01). Median transaminase levels were found to be significantly increased in patients with, as compared to patients without, acute GVHD (GPT 412 vs 28 IU/l; P = 0.03). Severe aplasia occurred in four and was a contributing cause of death in two patients. Overall, four patients died as a consequence of DLI and all received >1 × 108/kg cells: the actuarial risk was 38% in group A and 14% in group B (P = 0.1). There were 10 complete and three partial cytogenetic responses: the actuarial probability at 5 years of being Ph negative was 69%: it was 46% for group A and 85% for group B (P = 0.1). The longest patient is now 6 years post-DLI, Ph negative, BCR-ABL negative. The actuarial 3 year survival is 38% in group A and 86% in group B (P = 0.06). The study confirms that DLI post-BMT is not innocuous and that there is a definite long-lasting antileukemic effect in patients with CML. It also suggests that: (1) the risk of developing GVHD correlates with the... [ABSTRACT FROM AUTHOR]
- Subjects :
- *LYMPHOCYTES
*MYELOID leukemia
*BONE marrow transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 02683369
- Volume :
- 19
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Bone Marrow Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 8884436
- Full Text :
- https://doi.org/10.1038/sj.bmt.1700762