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Blood, 1 October 2007, Vol. 110, No. 7, pp. 2761-2763. Prepublished online as a Blood First Edition Paper on June 19, 2007; DOI 10.1182/blood-2007-05-090340. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-05-090340v1 110/7/2761    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Miller, J. S. Articles by Blazar, B. R. Search for Related Content PubMed PubMed Citation Articles by Miller, J. S. Articles by Blazar, B. R. Related Collections Immunobiology Transplantation Brief Reports Clinical Trials and Observations Related Articles in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Brief Report Lymphodepletion followed by donor lymphocyte infusion (DLI) causes significantly more acute graft-versus-host disease than DLI alone Jeffrey S. Miller1, Daniel J. Weisdorf1, Linda J. Burns1, Arne Slungaard1, John E. Wagner2, Michael R. Verneris2, Sarah Cooley1, Rosanna Wangen3, Susan K. Fautsch3, Roby Nicklow3, Todd DeFor3, and Bruce R. Blazar2 1 Division of Hematology, Oncology and Transplantation, Department of Medicine 2 Division of Pediatric Hematology, Oncology and Transplantation, Department of Pediatrics 3 Blood and Marrow Transplant Program and Cancer Center, University of Minnesota Cancer Center, Minneapolis Donor lymphocyte infusions (DLIs) can produce lasting remissions in patients with relapsed chronic myeloid leukemia (CML), but are less effective in non-CML diseases. We hypothesized that lymphodepletion, achieved with cyclophosphamide (Cy) and fludarabine (Flu), would promote in vivo expansion of the infused lymphocytes enhancing their immunologic effects. Fifteen patients with relapsed non-CML disease who received Cy/Flu/DLI were compared with 63 controls who received DLI without chemotherapy. Only the patients receiving Cy/Flu/DLI became lymphopenic at the time of DLI. Compared with controls, patients who received Cy/Flu/DLI developed significantly more grades II to IV (60% vs 24%, P = .01) and grades III to IV acute graft-versus-host disease (GVHD) (47% vs 14%, P = .01) with greater GVHD lethality. In Cy/Flu/DLI patients, T-cell proliferation was elevated at 14 days after DLI. Although these data suggest that chemotherapy-induced lymphodepletion enhances activation of donor lymphocytes, the toxicity needs to be managed before testing whether better disease control can be achieved. This trial was registered at www.clinicaltrials.gov as no. NCT00303693 [ClinicalTrials.gov] and www.cancer.gov/clinicaltrials as no. NCT00167180 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Articles in Blood Online: Searching for factors to improve the antileukemic effect of donor lymphocyte infusion Sébastien Maury, Catherine Cordonnier, Mathieu Kuentz, David Klatzmann, and José L. Cohen Blood 2008 111: 5256. [Full Text] [PDF] Response: The role of G-CSF on the risk of graft-versus-host disease after donor lymphocyte infusions Jeffrey S. Miller and Bruce R. Blazar Blood 2008 111: 5256-5257. [Full Text] [PDF] This article has been cited by other articles: S. Maury, C. Cordonnier, M. Kuentz, D. Klatzmann, and J. L. Cohen Searching for factors to improve the antileukemic effect of donor lymphocyte infusion Blood, May 15, 2008; 111(10): 5256 - 5256. [Full Text] [PDF] J. S. Miller and B. R. Blazar Response: The role of G-CSF on the risk of graft-versus-host disease after donor lymphocyte infusions Blood, May 15, 2008; 111(10): 5256 - 5257. [Full Text] [PDF] S. Mackinnon Donor Lymphocyte Infusion after Allogeneic Stem Cell Transplantation ASCO Educational Book, January 1, 2008; 2008(1): 334 - 337. [Abstract] [Full Text] [PDF]

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