Long term disease-free survival in acute leukemia patients recovering with increased γδ T cells after partially mismatched related donor bone marrow transplantation

K. T. Godder, P. J. Henslee-Downey, J. Mehta, B. S. Park, K. Y. Chiang, S. Abhyankar, L. S. Lamb

Research output: Contribution to journalArticle

139 Scopus citations

Abstract

Allogeneic stem cell transplantation (ASCT) has improved leukemia-free survival (LFS) in many but not all patients with acute leukemia. This is an eight-year follow-up to our previous study showing a survival advantage to patients with an increased γδ T cells following ASCT. γδ T cell levels were collected prospectively in 153 patients (acute lymphoblastic leukemia (ALL) n = 77; acute myelogenous leukemia (AML) n = 76) undergoing partially mismatched related donor ASCT. Median age was 22 years (1-59), and 62% of the patients were in relapse at transplant. Patient-donor human leukocyte antigen (HLA) disparity of three antigens was 37% in the graft-versus-host disease (GvHD) and 29% in the rejection directions. All patients received a partially T cell-depleted graft using T10B9 (n = 46) or OKT3 (n = 107). Five years LFS and overall survival (OS) of patients with increased γδ compared to those with normal/decreased numbers were 54.4 vs 19.1%; P < 0.0003, and 70.8 vs 19.6% P < 0.0001, respectively, with no difference in GvHD (P = 0.96). In a Cox multivariate analysis, normal/decreased γδ (hazard ratio (HR) 4.26, P = 0.0002) and sex mismatch (HR 1.45 P = 0.049) were associated with inferior LFS. In conclusion, γδ T cells may facilitate a graft-versus-leukemia (GvL) effect, without causing GvHD. Further evaluations of this effect may lead to specific immunotherapy for patients with refractory leukemia.

Original languageEnglish (US)
Pages (from-to)751-757
Number of pages7
JournalBone marrow transplantation
Volume39
Issue number12
DOIs
StatePublished - Jun 1 2007

    Fingerprint

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this