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Blood, 15 November 2004, Vol. 104, No. 10, pp. 3361-3363.
Prepublished online as a Blood First Edition Paper on August 3, 2004; DOI 10.1182/blood-2004-05-2031.
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Submitted May 28, 2004
Accepted July 12, 2004
Low dose Thalidomide and donor lymphocyte infusion as adoptive immunotherapy after allogeneic stem cell transplantation in patients with multiple myeloma
Nicolaus Kroger*, Avichai Shimoni, Maria Zagrivnaja, Francis Ayuk, Michael Lioznov, Heike Schieder, Helmut Renges, Boris Fehse, Tatjana Zabelina, Arnon Nagler, and Axel R Zander
Bone Marrow Transplantation, University Hospital, Hamburg, Germany
Dept. of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel Hashomer, Israel
* Corresponding author; email: nkroeger{at}uke.uni-hamburg.de.
To improve anti-myeloma effect of donor lymphocyte infusion (DLI) after allogeneic stem cell transplantation in multiple myeloma, we investigated in a phase I/II study the effect of low dose thalidomide (100 mg) followed by DLI in 18 patients with progressive disease or residual disease and prior ineffective DLI after allografting. The overall response rate was 67% including 22% complete remission. Major toxicity of thalidomide was weakness grade I/II (68%) and peripheral neuropathy grade I/II (28%). Only 2 patients experienced mild grade I acute graft versus host disease (aGvHD) of the skin, while no grade II-IV aGvHD was seen. De novo limited chronic GvHD (cGvHD) was seen in two patients (11%). The two-years estimated overall and progression-free survival was 100 % and 84%, respectively. Adoptive immunotherapy with low dose Thalidomide and DLI induces strong anti-myeloma effect with low incidence of graft versus host disease.
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