Prospective trial of high-dose chemotherapy followed by infusions of peripheral blood stem cells and dose-escalated donor lymphocytes for relapsed leukemia after allogeneic stem cell transplantation

International Journal of Hematology
Akiyoshi TakamiShinji Nakao

Abstract

To determine whether induction of graft-versus-host disease (GVHD) improves the outcome of acute relapsed leukemia after stem cell transplantation (SCT), we used high-dose cytarabine (ara-C) followed by infusions of donor-derived buffy coats containing peripheral blood stem cells to treat 12 patients with relapsed leukemia. Donor lymphocyte infusion (DLI) was repeated at least twice over a 5-week interval for patients in whom grade II to IV acute GVHD did not develop after the first DLI. Grade II to IV acute GVHD developed in 4 (33%) of the patients. Chronic GVHD developed in 3 patients, 2 of whom had not experienced acute GVHD. Four (67%) of the 6 patients who developed grade II to IV acute and/or chronic GVHD after DLI responded, but none of the other 6 patients responded. Four (33%) of the patients (2 with acute myelogenous leukemia [AML] and 2 with acute lymphoblastic leukemia [ALL]) achieved complete remission lasting longer than 4 months after the first DLI, but 3 of them had relapses in bone sites. Of these 4 patients, 1 patient with AML and 2 with ALL were alive 8 to 27 months after DLI. These findings indicate that high-dose ara-C combined with megadose DLI may produce durable remission of acute leukemia that has relap...Continue Reading

References

Apr 24, 1975·The New England Journal of Medicine·E D ThomasC D Buckner
Aug 1, 1980·The American Journal of Medicine·H M ShulmanE D Thomas
Feb 1, 1997·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·R H CollinsJ Nemunaitis
Oct 6, 2000·Bone Marrow Transplantation·R H CollinsP Parker
Aug 16, 2001·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·A BosiUNKNOWN Acute Leukemia Working Party of the European Blood and Marrow Transplant Group
Jan 12, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·John E LevineRobert H Collins
Sep 6, 2003·Blood·Hans-Jochem KolbDolores J Schendel

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Citations

Mar 2, 2011·Cancer Biotherapy & Radiopharmaceuticals·Robert O Dillman
Oct 13, 2007·Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine·Shinji Nakao
Dec 5, 2013·International Journal of Hematologic Oncology·Lindsay Am ReinDavid A Rizzieri
Sep 16, 2008·Best Practice & Research. Clinical Haematology·Robert J Soiffer
Apr 24, 2007·Best Practice & Research. Clinical Haematology·F Dazzi, C Fozza
May 29, 2012·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Satoshi YoshiharaHiroyasu Ogawa
Dec 29, 2016·Experimental Hematology·Guillermo OrtiDavid Valcarcel
Jul 27, 2011·Expert Review of Clinical Immunology·Aleksandra Petrovic, Gregory Hale

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