A pilot study of prophylactic donor lymphocyte infusions to prevent relapse in adult acute lymphoblastic leukemias after allogeneic hematopoietic stem cell transplantation

Bone Marrow Transplantation
C LutzR Arnold

Abstract

The outcome of patients with acute lymphoblastic leukemia (ALL) receiving therapeutic donor lymphocyte infusions (DLIs) in relapse after stem cell transplantation (SCT) is poor. We analyzed the impact of prophylactic DLIs in ALL on chimerism and sustained complete remission (CR). Eighty-five patients with ALL were allografted between January 1998 and September 2004. Twenty-six of them received prophylactic DLIs and were included in this analysis. A total of 12 of 13 patients, who were treated with mixed chimerism (MC) converted to complete donor chimerism (92%) and 10 of 12 patients had persistent donor chimerism and sustained CR during subsequent follow-up. Overall, 18 of 26 patients developed graft-versus-host disease (GVHD) after DLIs (69%), acute GVHD in 46 and chronic GVHD in 62%. After a median follow-up of 42 months (14-72) after SCT, 18 of 26 patients (70%) are alive, 16 in CR. Probability of event-free survival (EFS) for patients treated with DLIs is 62%, and overall survival is 70% at 3 years. Our preliminary data support a graft-versus-leukemia effect of prophylactic DLIs able to induce stable donor chimerism and ongoing CR after SCT. As the accompanying GVHD rate was considerable, careful selection of patients for p...Continue Reading

References

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Citations

Apr 29, 2010·Current Hematologic Malignancy Reports·Theis H TerweyRenate Arnold
Jul 29, 2008·Bone Marrow Transplantation·J L Liesveld, P G Rothberg
Mar 2, 2011·Cancer Biotherapy & Radiopharmaceuticals·Robert O Dillman
Dec 19, 2012·Annals of Oncology : Official Journal of the European Society for Medical Oncology·T H TerweyR Arnold
Dec 17, 2008·Hematology·Navneet S Majhail
Nov 19, 2011·Hematology/oncology Clinics of North America·Oana Paun, Hillard M Lazarus
Apr 14, 2010·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Zeynep Arzu YeginGülsan Türköz Sucak
Jun 20, 2008·British Journal of Haematology·A John Barrett
Jun 8, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Theis Helge TerweyRenate Arnold
Apr 1, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Nirali N ShahAllen R Chen
Aug 9, 2012·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Maria LigaAlexandros Spyridonidis
May 25, 2016·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Luca CastagnaLucio Morabito
Dec 1, 2011·Therapeutic Advances in Hematology·Alison Rager, David L Porter
Apr 25, 2012·Hematology·Hillard M Lazarus
Jul 16, 2020·Journal of Clinical Medicine·Sylvain LamurePatrice Ceballos
Jan 13, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Christoph SchmidGesine Bug

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