Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population

J. E. Levine, A. J. Barrett, M. J. Zhang, M. Arora, M. A. Pulsipher, N. Bunin, J. Fort, F. Loberiza, D. Porter, S. Giralt, W. Drobyski, D. Wang, S. Pavletic, O. Ringden, M. M. Horowitz, R. Collins

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Donor leukocyte infusions (DLI) can reverse relapse of hematologic malignancy following allogeneic hematopoietic stem cell transplant (HSCT) in some cases. Little is known regarding the effectiveness of DLI in children who relapse after HSCT. We report outcomes of 49 children who received DLI for relapse after allogeneic transplant. Prognosis was particularly poor (0/14 responses) for patients relapsing within 6 months from transplant. DLI rarely induced remission when given as sole therapy for marrow relapse. One-year disease-free survival was 30% (6/20) in patients who received DLI as consolidation following chemotherapy. The development of GVHD grades 1-2 was associated with superior 3-year survival than patients who developed GVHD grades 3-4 (P<0.002). To determine the benefit of DLI, 45 children who received DLI for relapse (four children without matches were excluded) were compared to 1229 children with similar characteristics whose relapse was not treated with DLI. There was no difference in survival (P=0.30) once adjustments were made to account for the time from relapse to DLI. Although a few children achieved durable remissions when DLI was used as part of a post-relapse treatment strategy, DLI was unsuccessful in the majority of cases. Strategies may be better directed at preempting post transplant relapse.

Original languageEnglish (US)
Pages (from-to)201-205
Number of pages5
JournalBone Marrow Transplantation
Volume42
Issue number3
DOIs
StatePublished - 2008

Fingerprint

Hematologic Neoplasms
Leukocytes
Tissue Donors
Pediatrics
Recurrence
Population
Transplants
Hematopoietic Stem Cells
Consolidation Chemotherapy
Survival
Disease-Free Survival
Bone Marrow

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population. / Levine, J. E.; Barrett, A. J.; Zhang, M. J.; Arora, M.; Pulsipher, M. A.; Bunin, N.; Fort, J.; Loberiza, F.; Porter, D.; Giralt, S.; Drobyski, W.; Wang, D.; Pavletic, S.; Ringden, O.; Horowitz, M. M.; Collins, R.

In: Bone Marrow Transplantation, Vol. 42, No. 3, 2008, p. 201-205.

Research output: Contribution to journalArticle

Levine, JE, Barrett, AJ, Zhang, MJ, Arora, M, Pulsipher, MA, Bunin, N, Fort, J, Loberiza, F, Porter, D, Giralt, S, Drobyski, W, Wang, D, Pavletic, S, Ringden, O, Horowitz, MM & Collins, R 2008, 'Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population', Bone Marrow Transplantation, vol. 42, no. 3, pp. 201-205. https://doi.org/10.1038/bmt.2008.135
Levine, J. E. ; Barrett, A. J. ; Zhang, M. J. ; Arora, M. ; Pulsipher, M. A. ; Bunin, N. ; Fort, J. ; Loberiza, F. ; Porter, D. ; Giralt, S. ; Drobyski, W. ; Wang, D. ; Pavletic, S. ; Ringden, O. ; Horowitz, M. M. ; Collins, R. / Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population. In: Bone Marrow Transplantation. 2008 ; Vol. 42, No. 3. pp. 201-205.
@article{926b854b8ef34c4fa825a1d501c77c30,
title = "Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population",
abstract = "Donor leukocyte infusions (DLI) can reverse relapse of hematologic malignancy following allogeneic hematopoietic stem cell transplant (HSCT) in some cases. Little is known regarding the effectiveness of DLI in children who relapse after HSCT. We report outcomes of 49 children who received DLI for relapse after allogeneic transplant. Prognosis was particularly poor (0/14 responses) for patients relapsing within 6 months from transplant. DLI rarely induced remission when given as sole therapy for marrow relapse. One-year disease-free survival was 30{\%} (6/20) in patients who received DLI as consolidation following chemotherapy. The development of GVHD grades 1-2 was associated with superior 3-year survival than patients who developed GVHD grades 3-4 (P<0.002). To determine the benefit of DLI, 45 children who received DLI for relapse (four children without matches were excluded) were compared to 1229 children with similar characteristics whose relapse was not treated with DLI. There was no difference in survival (P=0.30) once adjustments were made to account for the time from relapse to DLI. Although a few children achieved durable remissions when DLI was used as part of a post-relapse treatment strategy, DLI was unsuccessful in the majority of cases. Strategies may be better directed at preempting post transplant relapse.",
author = "Levine, {J. E.} and Barrett, {A. J.} and Zhang, {M. J.} and M. Arora and Pulsipher, {M. A.} and N. Bunin and J. Fort and F. Loberiza and D. Porter and S. Giralt and W. Drobyski and D. Wang and S. Pavletic and O. Ringden and Horowitz, {M. M.} and R. Collins",
year = "2008",
doi = "10.1038/bmt.2008.135",
language = "English (US)",
volume = "42",
pages = "201--205",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "3",

}

TY - JOUR

T1 - Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population

AU - Levine, J. E.

AU - Barrett, A. J.

AU - Zhang, M. J.

AU - Arora, M.

AU - Pulsipher, M. A.

AU - Bunin, N.

AU - Fort, J.

AU - Loberiza, F.

AU - Porter, D.

AU - Giralt, S.

AU - Drobyski, W.

AU - Wang, D.

AU - Pavletic, S.

AU - Ringden, O.

AU - Horowitz, M. M.

AU - Collins, R.

PY - 2008

Y1 - 2008

N2 - Donor leukocyte infusions (DLI) can reverse relapse of hematologic malignancy following allogeneic hematopoietic stem cell transplant (HSCT) in some cases. Little is known regarding the effectiveness of DLI in children who relapse after HSCT. We report outcomes of 49 children who received DLI for relapse after allogeneic transplant. Prognosis was particularly poor (0/14 responses) for patients relapsing within 6 months from transplant. DLI rarely induced remission when given as sole therapy for marrow relapse. One-year disease-free survival was 30% (6/20) in patients who received DLI as consolidation following chemotherapy. The development of GVHD grades 1-2 was associated with superior 3-year survival than patients who developed GVHD grades 3-4 (P<0.002). To determine the benefit of DLI, 45 children who received DLI for relapse (four children without matches were excluded) were compared to 1229 children with similar characteristics whose relapse was not treated with DLI. There was no difference in survival (P=0.30) once adjustments were made to account for the time from relapse to DLI. Although a few children achieved durable remissions when DLI was used as part of a post-relapse treatment strategy, DLI was unsuccessful in the majority of cases. Strategies may be better directed at preempting post transplant relapse.

AB - Donor leukocyte infusions (DLI) can reverse relapse of hematologic malignancy following allogeneic hematopoietic stem cell transplant (HSCT) in some cases. Little is known regarding the effectiveness of DLI in children who relapse after HSCT. We report outcomes of 49 children who received DLI for relapse after allogeneic transplant. Prognosis was particularly poor (0/14 responses) for patients relapsing within 6 months from transplant. DLI rarely induced remission when given as sole therapy for marrow relapse. One-year disease-free survival was 30% (6/20) in patients who received DLI as consolidation following chemotherapy. The development of GVHD grades 1-2 was associated with superior 3-year survival than patients who developed GVHD grades 3-4 (P<0.002). To determine the benefit of DLI, 45 children who received DLI for relapse (four children without matches were excluded) were compared to 1229 children with similar characteristics whose relapse was not treated with DLI. There was no difference in survival (P=0.30) once adjustments were made to account for the time from relapse to DLI. Although a few children achieved durable remissions when DLI was used as part of a post-relapse treatment strategy, DLI was unsuccessful in the majority of cases. Strategies may be better directed at preempting post transplant relapse.

UR - http://www.scopus.com/inward/record.url?scp=50049106424&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=50049106424&partnerID=8YFLogxK

U2 - 10.1038/bmt.2008.135

DO - 10.1038/bmt.2008.135

M3 - Article

C2 - 18490913

AN - SCOPUS:50049106424

VL - 42

SP - 201

EP - 205

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 3

ER -