Treatment of relapsed leukemia after unrelated donor marrow transplantation with unrelated donor leukocyte infusions Journal Article

  

Authors:	Porter, D. L.; Collins, R. H.; Hardy, C.; Kernan, N. A.; Drobyski, W. R.; Giralt, S.; Flowers, M. E. D.; Casper, J.; Leahey, A.; Parker, P.; Mick, R.; Bate-Boyle, B.; King, R.; Antin, J. H.
Article Title:	Treatment of relapsed leukemia after unrelated donor marrow transplantation with unrelated donor leukocyte infusions
Abstract:	The efficacy and toxicity of donor leukocyte infusions (DLI) after unrelated donor bone marrow transplantation (BMT) is largely unknown. We identified 58 recipients of unrelated DLI (UDLI) for the treatment of relapsed disease from the National Marrow Donor Program database. A retrospective analysis was performed to determine response, toxicity, and survival after UDLI and to identify factors associated with successful therapy. UDLI was administered for relapsed chronic myelogenous leukemia (CML) (n = 25), acute myelogenous leukemia (AML) (n = 23), acute lymphoblastic leukemia (ALL) (n = I), and other diseases (n = 3). Eight patients were in complete remission (CR) before UDLI, and 50 were evaluable for response. Forty-two percent (95% confidence interval [CI], 28%-56%) achieved CR, including 11 of 24 (46%; 95% CI, 26%-66%) with CML, 8 of 19(42%; 95% CI, 20%-64%) with AML, and 2 of 4 (50%; 95% CI, 1%-99%) with ALL. The estimated probability of disease-free survival (DFS) at 1 year after CR was 65% (95% CI, 50%-79%) for CML, 23% (95% CI, 9%-38%) for AML, and 30% (95% CI, 6%-54%) for ALL. Acute graft-versus-host disease (GVHD) complicated UDLI in 37% of patients (grade II-IV, 25%). A total of 13 of 32 evaluable patients (41%) developed chronic GVHD. There was no association between cell dose administered and either response or toxicity. In a multivariable analysis, only a longer interval from BMT to relapse and BMT to UDLI was associated with improved survival and DFS, respectively. UDLI is an acceptable alternative to other treatment options for relapse after unrelated donor BMT. (Blood. 2000;95:1214-1221) (C) 2000 by The American Society of Hematology.
Keywords:	toxicity; lymphocytes; adoptive immunotherapy; chronic myelogenous leukemia; efficacy; cells; chronic myeloid-leukemia; polymerase; transfusions; chain-reaction; versus-host disease
Journal Title:	Blood
Volume:	95
Issue:	4
ISSN:	0006-4971
Publisher:	American Society of Hematology
Date Published:	2000-02-15
Start Page:	1214
End Page:	1221
Language:	English
ACCESSION:	WOS:000085261600018
PROVIDER:	wos
PUBMED:	10666193
DOI:	10.1182/blood.V95.4.1214.004k46_1214_1221
Notes:	Article -- Source: Wos

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