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Blood, 15 February 2004, Vol. 103, No. 4, pp. 1548-1556. Prepublished online as a Blood First Edition Paper on October 23, 2003; DOI 10.1182/blood-2003-05-1513. This Article Full Text (PDF) All Versions of this Article: 2003-05-1513v1 103/4/1548    most recent Alert me when this article is cited Alert me if a correction is posted 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 Peggs, K. S Articles by Mackinnon, S. Search for Related Content PubMed PubMed Citation Articles by Peggs, K. S Articles by Mackinnon, S. Related Collections Related Letter in Blood Online Social Bookmarking                   What's this? Submitted May 13, 2003 Accepted October 8, 2003 Dose escalated donor lymphocyte infusions following reduced intensity transplantation: toxicity, chimerism, and disease responses Karl S Peggs*, Kirsty Thomson, Daniel P Hart, Johanne Geary, Emma C Morris, Kwee Yong, Anthony H Goldstone, David C Linch, and Stephen Mackinnon Department of Haematology, University College London Hospitals, London, United Kingdom * Corresponding author; email: kpeggs{at}hotmail.com. Data informing the application of donor lymphocyte infusions (DLI) following reduced intensity transplantation (RIT) remain limited. Persistence of host antigen presenting cells might increase the efficacy and/or toxicity of cellular immunotherapies. We report the results of dose-escalating DLI in 46 patients undergoing RIT, who received a total of 109 infusions to treat mixed chimerism, residual or progressive disease. Diagnoses were myeloma (n=19), Hodgkin lymphoma (n=13), non-Hodgkin lymphoma (n=10) and other (n=4). Thirty-two had an HLA-matched family donor and 14 an unrelated donor. Grade II-IV GVHD occurred in 5 sibling and 7 unrelated donor recipients. GVHD was more common (p=0.002), occurred at lower T-cell doses, and was more severe in the unrelated donor cohort. Conversion from mixed to multi-lineage full donor chimerism occurred in 30/35 evaluable patients. Presence of mixed chimerism in the granulocyte lineage at the time of DLI did not predict for chimerism response or GVHD. Disease responses occurred in 63% myeloma and 70% Hodgkin lymphoma patients and were not predicted by changes in chimerism. These data support the presence of clinically relevant graft-versus-Hodgkin activity, and indicate that DLI may be associated with a significantly increased toxicity in unrelated compared to sibling donor transplant recipients receiving identical treatment protocols. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? 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