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Blood, 1 June 2004, Vol. 103, No. 11, pp. 4362-4364.
Prepublished online as a Blood First Edition Paper on February 19, 2004; DOI 10.1182/blood-2003-11-3862.
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TRANSPLANTATION
Brief report
The occurrence of graft-versus-host disease is the major predictive factor for response to donor lymphocyte infusions in multiple myeloma
Henk M. Lokhorst,
Kalung Wu,
Leo F. Verdonck,
Laurens L. Laterveer,
Niels W. C. J. van de Donk,
Marinus H. J. van Oers,
Jan J. Cornelissen, and
Anton V. Schattenberg
From the Departments of Hematology, University Medical Centers of Utrecht, Rotterdam, Nijmegen, and Amsterdam, The Netherlands.
The graft-versus-myeloma (GVM) effect of donor lymphocyte infusions (DLIs) is well established. We now report the outcome of DLI in 54 patients with relapsed myeloma following allogeneic transplantation. Twenty-eight patients (52%) responded, 19 patients (35%) with a partial response and 9 patients (17%) with a complete response. Progression-free and overall survival were 19 and 23 months, respectively. We found that acute and chronic graft-versus-host disease (GVHD) observed in 57% and 47% of patients, respectively, following DLI were the strongest predictors for response. This suggests that targets for GVHD and GVM are identical. In a subgroup analysis, deletion of chromosome 13, as determined by double-color fluorescence in situ hybridization (FISH), had no impact on outcome, indicating that these patients are candidates for early allogeneic transplantation followed by DLI, in case of insufficient response. (Blood. 2004;103:4362-4364)
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