Impact of donor lymphocyte infusion for hematological malignancy relapsed after allogeneic bone marrow transplantation

Kirsten Zeder, Edmund K. Waller, Istvan Redei, D. Gerard Connaghan, William Fleming, Robert B. Geller, Leonard T. Heffner, Christopher D. Hillyer, Jeannine Holden, Kent Holland, Wayne Jones, Joan Mccollum, Mark Mogul, Carol Phillips, Glenn Rodey, John R. Wingard, Elliott Winton, Andrew M. Yeager, Steve Devine

Research output: Contribution to journalArticle

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Abstract

We studied the ability of donor lymphocytes collected by leukapheresis to induce graft-versus-leukemia-reactions in fifteen patients (6 CML, 4 AML, 2 ALL, and 3 high grade NHL) that had relapsed after allogeneic bone marrow transplantation. Eight donors were mobilized with G-CSF before collecting lymphocytes by apheresis. The patients were monitored for toxic effects and hematological and cytogenetic responses. Eight patients (53%) responded to the donor lymphocyte infusions (DLI). Four of six patients with relapsed CML had molecular remissions with no detectable cells containing bcr/abl messenger RNA transcripts. One of four AML patients and three of five patients with ALL/NHL showed complete hematological and/or cytogenetic remissions after DLI. Response rates were greater in patients who received more than 1 x 108 CD 3+ cells/kg and in patients who relapsed more than 6 months after BMT (p = NS). Response to DLI was significantly associated with the development of acute or chronic graft versus host disease. Seven of nine patients with clinical evidence of GvHD following donor lymphocyte infusion had a hematological and/or cytogenetic response to DLI compared to one of six patients who achieved a CR following DLI without evidence of GVHD (p = .05). Four patients who achieved complete remissions following DLI remain alive in CR eight to 29 months (median 18 months) after DLI (2 CML, 2 ALL/immunoblastic NHL). We conclude that DLI can be effective for ALL and NHL as well as CML, and that G-CSF stimulation of donors did not produce a significant change in the frequencies of either remission and/or GVHD post DLI.

Original languageEnglish (US)
Pages (from-to)221-228
Number of pages8
JournalCancer Research Therapy and Control
Volume5
Issue number4
StatePublished - 1998
Externally publishedYes

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Homologous Transplantation
Hematologic Neoplasms
Bone Marrow Transplantation
Tissue Donors
Lymphocytes
Cytogenetics
Granulocyte Colony-Stimulating Factor
Leukapheresis
Blood Component Removal
Poisons
Graft vs Host Disease
Leukemia

Keywords

  • Adoptive immunotherapy
  • Donor lymphocyte infusions

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Zeder, K., Waller, E. K., Redei, I., Gerard Connaghan, D., Fleming, W., Geller, R. B., ... Devine, S. (1998). Impact of donor lymphocyte infusion for hematological malignancy relapsed after allogeneic bone marrow transplantation. Cancer Research Therapy and Control, 5(4), 221-228.

Impact of donor lymphocyte infusion for hematological malignancy relapsed after allogeneic bone marrow transplantation. / Zeder, Kirsten; Waller, Edmund K.; Redei, Istvan; Gerard Connaghan, D.; Fleming, William; Geller, Robert B.; Heffner, Leonard T.; Hillyer, Christopher D.; Holden, Jeannine; Holland, Kent; Jones, Wayne; Mccollum, Joan; Mogul, Mark; Phillips, Carol; Rodey, Glenn; Wingard, John R.; Winton, Elliott; Yeager, Andrew M.; Devine, Steve.

In: Cancer Research Therapy and Control, Vol. 5, No. 4, 1998, p. 221-228.

Research output: Contribution to journalArticle

Zeder, K, Waller, EK, Redei, I, Gerard Connaghan, D, Fleming, W, Geller, RB, Heffner, LT, Hillyer, CD, Holden, J, Holland, K, Jones, W, Mccollum, J, Mogul, M, Phillips, C, Rodey, G, Wingard, JR, Winton, E, Yeager, AM & Devine, S 1998, 'Impact of donor lymphocyte infusion for hematological malignancy relapsed after allogeneic bone marrow transplantation', Cancer Research Therapy and Control, vol. 5, no. 4, pp. 221-228.
Zeder, Kirsten ; Waller, Edmund K. ; Redei, Istvan ; Gerard Connaghan, D. ; Fleming, William ; Geller, Robert B. ; Heffner, Leonard T. ; Hillyer, Christopher D. ; Holden, Jeannine ; Holland, Kent ; Jones, Wayne ; Mccollum, Joan ; Mogul, Mark ; Phillips, Carol ; Rodey, Glenn ; Wingard, John R. ; Winton, Elliott ; Yeager, Andrew M. ; Devine, Steve. / Impact of donor lymphocyte infusion for hematological malignancy relapsed after allogeneic bone marrow transplantation. In: Cancer Research Therapy and Control. 1998 ; Vol. 5, No. 4. pp. 221-228.
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AU - Fleming, William

AU - Geller, Robert B.

AU - Heffner, Leonard T.

AU - Hillyer, Christopher D.

AU - Holden, Jeannine

AU - Holland, Kent

AU - Jones, Wayne

AU - Mccollum, Joan

AU - Mogul, Mark

AU - Phillips, Carol

AU - Rodey, Glenn

AU - Wingard, John R.

AU - Winton, Elliott

AU - Yeager, Andrew M.

AU - Devine, Steve

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N2 - We studied the ability of donor lymphocytes collected by leukapheresis to induce graft-versus-leukemia-reactions in fifteen patients (6 CML, 4 AML, 2 ALL, and 3 high grade NHL) that had relapsed after allogeneic bone marrow transplantation. Eight donors were mobilized with G-CSF before collecting lymphocytes by apheresis. The patients were monitored for toxic effects and hematological and cytogenetic responses. Eight patients (53%) responded to the donor lymphocyte infusions (DLI). Four of six patients with relapsed CML had molecular remissions with no detectable cells containing bcr/abl messenger RNA transcripts. One of four AML patients and three of five patients with ALL/NHL showed complete hematological and/or cytogenetic remissions after DLI. Response rates were greater in patients who received more than 1 x 108 CD 3+ cells/kg and in patients who relapsed more than 6 months after BMT (p = NS). Response to DLI was significantly associated with the development of acute or chronic graft versus host disease. Seven of nine patients with clinical evidence of GvHD following donor lymphocyte infusion had a hematological and/or cytogenetic response to DLI compared to one of six patients who achieved a CR following DLI without evidence of GVHD (p = .05). Four patients who achieved complete remissions following DLI remain alive in CR eight to 29 months (median 18 months) after DLI (2 CML, 2 ALL/immunoblastic NHL). We conclude that DLI can be effective for ALL and NHL as well as CML, and that G-CSF stimulation of donors did not produce a significant change in the frequencies of either remission and/or GVHD post DLI.

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