title: [Treatment of leukemia relapsed after allogenic bone marrow transplantation with donor lymphocyte infusion: report of 11 cases].
abstract: OBJECTIVE
  Donor leukocyte infusions (DLI) are useful for treating leukaemic relapse after allogeneic bone marrow transplantation (BMT). We reviewed our experience with eleven patients who received DLI between 1995 and 1997.
  
  
  METHODS
  The diagnoses prior to DLI were: chronic myeloid leukaemia (CML) in chronic phase (CP) (two patients) or accelerated phase (two patients), acute myeloid leukaemia (AML) (two patients), acute lymphoid leukaemia (ALL) (two patients), and refractory anaemia with excess blasts under transformation (tRAEB) (three patients). The patients received a median of 1.72 x 10(8) CD3+ cells/Kg (range: 0.58 x 10(8) CD3+ cells/Kg). Four patients were infused cryopreserved cells. Six patients received interferon alpha (IFN alpha) concomitantly.
  
  
  RESULTS
  Seven patients (four CML, one AML, one ALL, one tRAEB) obtained complete remission (CR). Graft-versus-host disease (GVHD) was observed in all patients with CR and one without response. Marrow hypoplasia or severe bicytopenia occurred in four patients. Of all patients achieving CR, two died after relapsing within 3 months of DLI, while three others died of GVHD. Four patients had no response to DLI or were not evauable. Only two patients--both with CML--are alive 1096 and 374 days after DLI, the former in clinical, cytogenetic and molecular CR, and the latter in second CP after 2 months in CR.
  
  
  CONCLUSIONS
  DLI results in CR in most patients with relapsing leukaemia or myelodysplasia after BMT, especially in CML patients. The anti-leukaemia effect is highly correlated with GVHD. This complication and marrow hypoplasia remain major causes of morbidity and mortality of this procedure.
authors.affiliation: Servicio de Hematología, Hospital Universitario de la Princesa, Madrid.
authors.forename: C
authors.initials: C
authors.lastname: Sanz Rodríguez
authors.forename: J L
authors.initials: JL
authors.lastname: Steegmann
authors.forename: A
authors.initials: A
authors.lastname: Granda
authors.forename: R
authors.initials: R
authors.lastname: de la Cámara
authors.forename: A
authors.initials: A
authors.lastname: Figuera
authors.forename: R
authors.initials: R
authors.lastname: Arranz
authors.forename: V
authors.initials: V
authors.lastname: Gómez-García de Soria
authors.forename: A
authors.initials: A
authors.lastname: Alegre
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández-Rañada
mesh_terms: D000328:Adult; D001782:Blood Donors; D016026:Bone Marrow Transplantation; D005260:Female; D006801:Humans; D007937:Leukapheresis; D007938:Leukemia / Q000628:therapy*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D017708:Leukocyte Transfusion; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D012008:Recurrence