Donor lymphocyte infusions effective for treatment of relapsed disease after ASCT

06-06-2006

Donor lymphocyte infusions are effective for the treatment of relapsed disease after allogeneic transplantation.

"We retrospectively analyzed 83 consecutive recipients of donor lymphocyte infusions (DLI) after allogeneic transplantation for factors associated with disease response and graft-versus-host disease (GVHD).

"DLI was highly effective in relapsed chronic phase chronic myeloid leukemia (CML), with 71% of patients achieving durable complete remissions (CR)," investigators in the United States report.

According to C.A. Huff and colleagues at Johns Hopkins University, "In relapsed acute myeloid leukemia, DLI led to durable CRs in 31% of patients; the rate was <20% in all other diseases.

"Achieving full donor chimerism and GVHD were predictive of CR. Grade II or higher acute or chronic GVHD occurred in 36 (43%) patients and contributed to death in 13 (16%)."

"Even more patients, 33 (40%), died of their underlying malignancy, including 10 who developed active GVHD. In relapsed CML, most durable CRs occurred without clinically apparent GVHD, yet all responders achieved full donor chimerism, including 6 with coincident normal host hematopoiesis at the time of DLI.

"Thus," the authors said, "in CML, potent lymphohematopoietic graft-versus-host reactions occurred even in the absence of clinically apparent GVHD; this confirms the ability to dissociate these processes and argues against a leukemia-specific immunologic effect."

Huff concluded, "DLI clearly has efficacy in the treatment of relapsed disease after allogeneic transplantation. However, with the exception of CML, most patients die of their underlying disease because of insufficient antitumor activity even with active GVHD."

Huff and colleagues published their study in Biology of Blood and Marrow Transplantation (Graft-versus-host reactions and the effectiveness of donor lymphocyte infusions. Biol Blood Marrow Transplant, 2006;12(4):414-421).

For additional information, contact C.A. Huff, Johns Hopkins University, Sidney Kimmel Comprehensive Cancer Center, Bunting Blaustein Cancer Research Bldg, 1650 Orleans St., R, Baltimore, MD 21231, USA.

The publisher of the journal Biology of Blood and Marrow Transplantation can be contacted at: Carden Jennings Publ Co. Ltd., Blake Center, Ste. 200, 1224 W Main St., Charlottesville, VA 22903, USA.

Keywords: Baltimore, Maryland, United States, Allogeneic Transplantation, Chronic Myeloid Leukemia, Disease Response, Donor Lymphocyte Infusions, Graft-Versus-Host Disease.

This article was prepared by Clinical Oncology Week editors from staff and other reports. Copyright 2006, Clinical Oncology Week via NewsRx.com.