Activated allogeneic cell therapy (allo-ACT) for relapsed chronic myelogenous leukemia (CML) refractory to buffy coat transfusions post-allogeneic bone marrow transplantation.
We describe a 17-year-old male patient with chronic myelogenous leukemia (CML) in hematologic and cytogenetic relapse 4 months post-non-T cell-depleted allogeneic bone marrow transplantation for accelerated CML. Two sequential buffy coat transfusion with donor peripheral blood cells (8.9 and 4.8 x 10(7) cells/kg), the second transfusion in combination with in vivo activation of donor cells by human recombinant interleukin-2 (rIL-2) 6 x 10(6) IU/m2 subcutaneously for 3 days, failed to induce remission . The patient responded to an infusion of donor peripheral blood lymphocytes (3.4 x 10(7) cells/kg) pre-activated in vivo with rIL-2 and additionally activated in vivo with rIL-2, 6 x 10(6) IU/m2/day subcutaneously for 3 days. Elimination of the Philadelphia (Ph) clone was confirmed by cytogenetic analysis showing a normal male karyotype and by disappearance of the bcr/abl transcript, using the polymerase chain reaction (PCR). At present, the patient is 26 months post-treatment with no evidence of disease, but with chronic graft-versus-host disease. Our data indicate that allogeneic activated cell therapy (allo-ACT) may provide antitumor effector cells that successfully induce graft-versus-leukemia (GVL) effects even when cell therapy with donor buffy coats was insufficient.
Kapelushnik
J
J
Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel.
Nagler
A
A
Or
R
R
Naparstek
E
E
Ackerstein
A
A
Samuel
S
S
Morecki
S
S
Nabet
C
C
Slavin
S
S
D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D007376:Interleukin-2 / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D015979:Killer Cells, Lymphokine-Activated / Q000637:transplantation*; D015465:Leukemia, Myeloid, Accelerated Phase / Q000628:therapy*; D017708:Leukocyte Transfusion / Q000009:adverse effects; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D012008:Recurrence; D016879:Salvage Therapy; D014184:Transplantation, Homologous
D007376:Interleukin-2; D011994:Recombinant Proteins