T cell and NK cell mediated graft-versus-leukaemia reactivity following donor buffy coat transfusion to treat relapse after marrow transplantation for chronic myeloid leukaemia.
Two patients with chronic myeloid leukaemia in cytogenetic relapse following T lymphocyte-depleted BMT were treated with transfusions of donor buffy coat leucocytes. In both patients the marrow reverted to a completely normal karyotype and was negative for the BCR-ABL fusion gene transcript by polymerase chain reaction analysis. Before buffy coat transfusion the cytotoxic T lymphocyte precursor frequency against pre-BMT patient leukaemia cells (Lk-CTLP) was lower than that against pre-BMT patient PHA-transformed lymphocytes (Ly-CTLP) in both cases. At 2 weeks (case 1) and 8 weeks (case 2) after transfusion this ratio inverted so that Lk-CTLP predominated. Natural killer (NK) function fell initially and then recovered to exceed pre-transfusion values prior to normalization of the bone marrow karyotype. These changes in cytotoxic T lymphocytes and NK cells following donor buffy coat transfusions for patients with relapsed chronic myeloid leukaemia after marrow transplantation support the concept of a graft-versus-leukaemia effect mediated by both MHC restricted and non-restricted pathways.
Jiang
Y Z
YZ
Department of Haematology, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
Cullis
J O
JO
Kanfer
E J
EJ
Goldman
J M
JM
Barrett
A J
AJ
D000328:Adult; D016913:Blood Component Transfusion; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000235:genetics; D005819:Genetic Markers; D006087:Graft vs Host Reaction; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology* / Q000637:transplantation; D015465:Leukemia, Myeloid, Accelerated Phase / Q000601:surgery / Q000628:therapy*; D015466:Leukemia, Myeloid, Chronic-Phase / Q000601:surgery / Q000628:therapy*; D008212:Lymphocyte Depletion; D008297:Male; D016133:Polymerase Chain Reaction; D012333:RNA, Messenger / Q000032:analysis; D016879:Salvage Therapy; D016176:T-Lymphocyte Subsets / Q000276:immunology* / Q000637:transplantation
D005819:Genetic Markers; D012333:RNA, Messenger; D016044:Fusion Proteins, bcr-abl