|
|
Prepublished online as a Blood First Edition Paper on July 5, 2002; DOI 10.1182/blood-2002-02-0506.
 Previous Article | Table of Contents | Next Article 
Blood, 1 November 2002, Vol. 100, No. 9, pp. 3108-3114
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
The toxicity and efficacy of donor lymphocyte infusions given
after reduced-intensity conditioning allogeneic stem cell
transplantation
David I. Marks,
Richard Lush,
Jamie Cavenagh,
Donald W. Milligan,
Steven Schey,
Anne Parker,
Fiona J. Clark,
Linda Hunt,
John Yin,
Steven Fuller,
Elisabeth Vandenberghe,
Judith Marsh,
Timothy Littlewood,
Graeme M. Smith,
Dominic Culligan,
Ann Hunter,
Rajesh Chopra,
Andrew Davies,
Keiren Towlson, and
Catherine D. Williams
From the institutions contributing data to the Clinical
Trials Committee Study and Departments of Haematology at Nottingham
City Hospital, St Bartholomew's and Royal London NHS Trust, Birmingham
Heartlands Hospital, Guy's and St Thomas' NHS Trust, Glasgow Royal
Infirmary, Queen Elizabeth Hospital Birmingham, Manchester Royal
Infirmary, Hammersmith Hospital, Royal Hallamshire Hospital Sheffield,
St George's Hospital London, John Radcliffe Hospital Oxford, Leeds
Blood and Marrow Transplant Centre, Aberdeen Royal Infirmary, Leicester
Royal Infirmary, Christie Hospital Manchester, and British Society of
Bone Marrow Transplantation Registry.
We describe the toxicity and efficacy of donor lymphocyte infusions
(DLIs) given to 81 patients (median age, 50 years) after reduced-intensity conditioning (RIC) transplantations
performed at 16 centers in the United Kingdom. The diseases treated
included non-Hodgkin lymphoma (NHL; n = 29), chronic myeloid leukemia
(CML; n = 12), myeloma (n = 11), acute myeloid leukemia (AML; n = 10), and chronic lymphocytic leukemia (CLL; n = 9).
Eighty-eight percent received stem cells from sibling donors. The
patients received 130 infusions (median, 1; range, 1-4). Indications
for DLI were unsatisfactory response/disease progression in 51 patients, mixed chimerism in 18, preemptive in 10, and other in 2. Graft hypoplasia was uncommon (11%). Grade II to IV graft-versus-host
disease (GVHD) occurred in 23 of 81 patients (28%) and limited and
extensive chronic GVHD in 5 of 69 and 18 of 69 evaluable patients
(total incidence 33%). Conversion from mixed to full donor chimerism occurred in 19 of 55 evaluable patients (35%) at a median of 48 days
after the DLI; partial responses occurred in 6 patients (total response
rate 45%). Eighteen of 51 (35%) patients with measurable disease
after stem cell transplantation had a complete response (2 molecular),
and 5 a partial response (total response rate 45%). Eleven of 17 evaluable complete responders had full donor chimerism. Eight of 13 patients with follicular NHL had complete responses as did 4 of 12 patients with CML. Clinical and chimeric responses correlated strongly
with acute and chronic GVHD. Forty-seven patients (58%) survive at a
median of 508 days after transplantation (range, 155-1171 days) with a
median Karnofsky score of 90. Thirty-four patients (42%) died at a
median of 211 days after transplantation with the major causes being
progressive disease (26%) and GVHD (9%). Further systematic studies
are required to determine the efficacy and optimum use of DLI for
patients with each disease treated by nonmyeloablative stem cell transplantation.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
M. Haniffa, F. Ginhoux, X.-N. Wang, V. Bigley, M. Abel, I. Dimmick, S. Bullock, M. Grisotto, T. Booth, P. Taub, et al.
Differential rates of replacement of human dermal dendritic cells and macrophages during hematopoietic stem cell transplantation
J. Exp. Med.,
February 16, 2009;
206(2):
371 - 385.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. J. Thomson, E. C. Morris, A. Bloor, G. Cook, D. Milligan, A. Parker, F. Clark, L. Yung, D. C. Linch, R. Chakraverty, et al.
Favorable Long-Term Survival After Reduced-Intensity Allogeneic Transplantation for Multiple-Relapse Aggressive Non-Hodgkin's Lymphoma
J. Clin. Oncol.,
January 20, 2009;
27(3):
426 - 432.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H.-J. Kolb
Graft-versus-leukemia effects of transplantation and donor lymphocytes
Blood,
December 1, 2008;
112(12):
4371 - 4383.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. R. Bishop, R. M. Dean, S. M. Steinberg, J. Odom, S. Z. Pavletic, C. Chow, S. Pittaluga, C. Sportes, N. M. Hardy, J. Gea-Banacloche, et al.
Clinical evidence of a graft-versus-lymphoma effect against relapsed diffuse large B-cell lymphoma after allogeneic hematopoietic stem-cell transplantation
Ann. Onc.,
November 1, 2008;
19(11):
1935 - 1940.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. F. Khouri, P. McLaughlin, R. M. Saliba, C. Hosing, M. Korbling, M. S. Lee, L. J. Medeiros, L. Fayad, F. Samaniego, A. Alousi, et al.
Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab
Blood,
June 15, 2008;
111(12):
5530 - 5536.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Valcarcel, R. Martino, D. Caballero, J. Martin, C. Ferra, J. B. Nieto, A. Sampol, M. T. Bernal, J. L. Pinana, L. Vazquez, et al.
Sustained Remissions of High-Risk Acute Myeloid Leukemia and Myelodysplastic Syndrome After Reduced-Intensity Conditioning Allogeneic Hematopoietic Transplantation: Chronic Graft-Versus-Host Disease Is the Strongest Factor Improving Survival
J. Clin. Oncol.,
February 1, 2008;
26(4):
577 - 584.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. G. Schuster, D. H. Busch, E. Eppinger, E. Kremmer, S. Milosevic, C. Hennard, C. Kuttler, J. W. Ellwart, B. Frankenberger, E. Nossner, et al.
Allorestricted T cells with specificity for the FMNL1-derived peptide PP2 have potent antitumor activity against hematologic and other malignancies
Blood,
October 15, 2007;
110(8):
2931 - 2939.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Farina and P. Corradini
Current role of allogeneic stem cell transplantation in follicular lymphoma
Haematologica,
May 1, 2007;
92(5):
580 - 582.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Bogunovic, F. Ginhoux, A. Wagers, M. Loubeau, L. M. Isola, L. Lubrano, V. Najfeld, R. G. Phelps, C. Grosskreutz, E. Scigliano, et al.
Identification of a radio-resistant and cycling dermal dendritic cell population in mice and men
J. Exp. Med.,
November 27, 2006;
203(12):
2627 - 2638.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Delgado, K. Thomson, N. Russell, J. Ewing, W. Stewart, G. Cook, S. Devereux, R. Lovell, R. Chopra, D. I. Marks, et al.
Results of alemtuzumab-based reduced-intensity allogeneic transplantation for chronic lymphocytic leukemia: a British Society of Blood and Marrow Transplantation Study
Blood,
February 15, 2006;
107(4):
1724 - 1730.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. P. Collin, D. N.J. Hart, G. H. Jackson, G. Cook, J. Cavet, S. Mackinnon, P. G. Middleton, and A. M. Dickinson
The fate of human Langerhans cells in hematopoietic stem cell transplantation
J. Exp. Med.,
January 23, 2006;
203(1):
27 - 33.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. P. Rettig, J. K. Ritchey, J. L. Prior, J. S. Haug, D. Piwnica-Worms, and J. F. DiPersio
Kinetics of In Vivo Elimination of Suicide Gene-Expressing T Cells Affects Engraftment, Graft-versus-Host Disease, and Graft-versus-Leukemia after Allogeneic Bone Marrow Transplantation
J. Immunol.,
September 15, 2004;
173(6):
3620 - 3630.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. I. Marks, A. Parker, and S. P. Robinson
Donor lymphocyte infusions after reduced intensity conditioning allogeneic transplantation: what we need to know
Blood,
July 1, 2004;
104(1):
295 - 296.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Y. Mapara and M. Sykes
Tolerance and Cancer: Mechanisms of Tumor Evasion and Strategies for Breaking Tolerance
J. Clin. Oncol.,
March 15, 2004;
22(6):
1136 - 1151.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. S. Peggs, K. Thomson, D. P. Hart, J. Geary, E. C. Morris, K. Yong, A. H. Goldstone, D. C. Linch, and S. Mackinnon
Dose-escalated donor lymphocyte infusions following reduced intensity transplantation: toxicity, chimerism, and disease responses
Blood,
February 15, 2004;
103(4):
1548 - 1556.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H.-J. Kolb, C. Schmid, A. J. Barrett, and D. J. Schendel
Graft-versus-leukemia reactions in allogeneic chimeras
Blood,
February 1, 2004;
103(3):
767 - 776.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. A. Bethge, U. Hegenbart, M. J. Stuart, B. E. Storer, M. B. Maris, M. E. D. Flowers, D. G. Maloney, T. Chauncey, B. Bruno, E. Agura, et al.
Adoptive immunotherapy with donor lymphocyte infusions after allogeneic hematopoietic cell transplantation following nonmyeloablative conditioning
Blood,
February 1, 2004;
103(3):
790 - 795.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. D. Faulkner, C. Craddock, J. L. Byrne, P. Mahendra, A. P. Haynes, H. G. Prentice, M. Potter, A. Pagliuca, A. Ho, S. Devereux, et al.
BEAM-alemtuzumab reduced-intensity allogeneic stem cell transplantation for lymphoproliferative diseases: GVHD, toxicity, and survival in 65 patients
Blood,
January 15, 2004;
103(2):
428 - 434.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D.C. Taussig, A.J. Davies, J.D. Cavenagh, H. Oakervee, D. Syndercombe-Court, S. Kelsey, J.A.L. Amess, A.Z.S. Rohatiner, T.A. Lister, and M.J. Barnett
Durable Remissions of Myelodysplastic Syndrome and Acute Myeloid Leukemia After Reduced-Intensity Allografting
J. Clin. Oncol.,
August 15, 2003;
21(16):
3060 - 3065.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. V. Melo, T. P. Hughes, and J. F. Apperley
Chronic Myeloid Leukemia
Hematology,
January 1, 2003;
2003(1):
132 - 152.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
