TY - JOUR
T1 - Donor leukocyte infusions in acute lymphocytic leukemia
AU - Collins, R. H.
AU - Goldstein, S.
AU - Giralt, S.
AU - Levine, J.
AU - Porter, D.
AU - Drobyski, W.
AU - Barrett, J.
AU - Johnson, M.
AU - Kirk, A.
AU - Horowitz, M.
AU - Parker, P.
N1 - Funding Information:
We thank Shanna Morris for data management, John Klein for statistical analysis, Jane Pryor for assistance in manuscript preparation and the Leukemia Association of North Central Texas for financial support.
PY - 2000
Y1 - 2000
N2 - Donor leukocyte infusion (DLI) has well-documented activity in CML but the role of DLI in other diseases is less well defined. To evaluate the strategy in acute lymphocytic leukemia (ALL) we evaluated 44 ALL patients from 27 centers who were treated with DLI. Patients with persistent or recurrent disease received DLI from the original marrow donor (30 matched related, four mismatched family, and 10 matched unrelated). Chemotherapy was given before DLI to 28 patients. Of 15 patients who received no pre-DLI chemotherapy, two achieved complete remissions, lasting 1112 and 764+ days. In four patients who received DLI as consolidation of remission induced by chemotherapy or immunosuppression-withdrawal, duration of remission post DLI was 65, 99, 195 and 672+ days. Of 25 patients who received DLI in the nadir after chemotherapy, 13 survived ≥ 30 days post DLI but did not achieve remission, seven died within less than 30 days post DLI, and five entered remissions that lasted 42, 68, 83, 90, 193 days. Seven patients who did not respond to the initial DLI received a second DLI; none of these patients attained durable remission. Eighteen of 37 evaluable patients developed acute GVHD and five of 20 evaluable patients developed chronic GVHD. Overall actuarial survival is 13% at 3 years. In conclusion, DLI has limited benefit in ALL. New approaches are needed in this group of patients.
AB - Donor leukocyte infusion (DLI) has well-documented activity in CML but the role of DLI in other diseases is less well defined. To evaluate the strategy in acute lymphocytic leukemia (ALL) we evaluated 44 ALL patients from 27 centers who were treated with DLI. Patients with persistent or recurrent disease received DLI from the original marrow donor (30 matched related, four mismatched family, and 10 matched unrelated). Chemotherapy was given before DLI to 28 patients. Of 15 patients who received no pre-DLI chemotherapy, two achieved complete remissions, lasting 1112 and 764+ days. In four patients who received DLI as consolidation of remission induced by chemotherapy or immunosuppression-withdrawal, duration of remission post DLI was 65, 99, 195 and 672+ days. Of 25 patients who received DLI in the nadir after chemotherapy, 13 survived ≥ 30 days post DLI but did not achieve remission, seven died within less than 30 days post DLI, and five entered remissions that lasted 42, 68, 83, 90, 193 days. Seven patients who did not respond to the initial DLI received a second DLI; none of these patients attained durable remission. Eighteen of 37 evaluable patients developed acute GVHD and five of 20 evaluable patients developed chronic GVHD. Overall actuarial survival is 13% at 3 years. In conclusion, DLI has limited benefit in ALL. New approaches are needed in this group of patients.
KW - Acute lymphocytic leukemia
KW - Adoptive immunotherapy
KW - Donor leukocyte infusions
UR - http://www.scopus.com/inward/record.url?scp=0033832579&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033832579&partnerID=8YFLogxK
U2 - 10.1038/sj.bmt.1702555
DO - 10.1038/sj.bmt.1702555
M3 - Article
C2 - 11019840
AN - SCOPUS:0033832579
SN - 0268-3369
VL - 26
SP - 511
EP - 516
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 5
ER -