Long-term follow-up of recipients of CD8-depleted donor lymphocyte infusions for the treatment of chronic myelogenous leukmeia relapsing after allogeneic progenitor cell transplantation

Avichai Shimoni, James Gajewski, Michele Donato, Thomas Martin, Susan O'Brien, Moshe Talpaz, Agueda Cohen, Martin Korbling, Richard Champlin, Sergio Giralt

    Research output: Contribution to journalArticle

    55 Scopus citations

    Abstract

    Donor lymphocyte infusions (DLIs) are an effective treatment for relapsed Chronic myeloid leukemia (CML) after allogeneic transplantation but are limited by the occurrence of GVHD. CD8+T lymphocytes are involved in the pathogenesis of GVHD but may not be essential for the graft-versus-leukemia (GVL) effect in CML. We have treated 26 CML patients with posttransplantation relapse with CD8-depleted DLI. Thirteen of 15 patients (87%) who relapsed in early-phase CML achieved complete cytogenetic response, but only 1 of 11 who relapsed in advanced-phase disease achieved complete response. Acute GVHD occurred in 2 patients (8%), and extensive chronic GVHD occurred in 2 patients (11%). Treatment-related mortality was 11.5%. Responses were durable; with a median follow-up of 4.2 years (1-7.5 years), only 1 responding patient relapsed (7%). CD8-depleted DLI was equally effective and safe after unrelated donor transplants and sibling transplants. Cytogenetic clonal evolution at the time of DLI was not predictive of treatment failure unless associated with hematologic criteria for disease acceleration. CD8 depletion is an effective method to separate GVL from GVHD for posttransplantation relapsed CML. This strategy is associated with durable complete remissions and a low rate of complications and therefore merits further investigation in larger-scale comparative trials.

    Original languageEnglish (US)
    Pages (from-to)568-575
    Number of pages8
    JournalBiology of Blood and Marrow Transplantation
    Volume7
    Issue number10
    DOIs
    StatePublished - Jan 1 2001

    Keywords

    • CD8 depletion
    • Chronic myeloid leukemia
    • Donor lymphocyte infusion
    • Graft-versus-host disease

    ASJC Scopus subject areas

    • Hematology
    • Transplantation

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