title: Donor leukocyte infusions for multiple myeloma.
abstract: 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 multiple myeloma (MM) we evaluated 25 MM patients from 15 centers who were treated with DLI. Patients with persistent or recurrent disease after allogeneic BMT received DLI from the original marrow donor (23 matched related, one mismatched family, and one matched unrelated). Chemotherapy was given before DLI in three patients. Two of 22 patients responded completely to DLI alone and three patients responded to the combination of DLI and chemotherapy. Nine patients who had not had sufficient disease control after DLI were given additional DLIs; five of these patients had either complete (two) or partial (three) responses. Thirteen of 25 evaluable patients developed acute GVHD and 11 of 21 evaluable patients developed chronic GVHD; all responders developed GVHD. No patients developed post-DLI pancytopenia. Four patients had responses which lasted >1 year after DLI, three patients had responses which lasted <1 year, and three patients had ongoing responses but with follow-up <1 year. In conclusion, DLI has anti-myeloma activity but the strategy is limited by no response or short duration of response in a significant percentage of patients and by significant GVHD in the majority of the responders.
authors.affiliation: University of Texas Southwestern Medical Center, Dallas 75390-8852, USA.
authors.forename: M
authors.initials: M
authors.lastname: Salama
authors.forename: T
authors.initials: T
authors.lastname: Nevill
authors.forename: D
authors.initials: D
authors.lastname: Marcellus
authors.forename: P
authors.initials: P
authors.lastname: Parker
authors.forename: M
authors.initials: M
authors.lastname: Johnson
authors.forename: A
authors.initials: A
authors.lastname: Kirk
authors.forename: D
authors.initials: D
authors.lastname: Porter
authors.forename: S
authors.initials: S
authors.lastname: Giralt
authors.forename: J E
authors.initials: JE
authors.lastname: Levine
authors.forename: W
authors.initials: W
authors.lastname: Drobyski
authors.forename: A J
authors.initials: AJ
authors.lastname: Barrett
authors.forename: M
authors.initials: M
authors.lastname: Horowitz
authors.forename: R H
authors.initials: RH
authors.lastname: Collins
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000276:immunology; D003131:Combined Modality Therapy; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology; D006801:Humans; D016219:Immunotherapy, Adoptive; D017708:Leukocyte Transfusion / Q000009:adverse effects; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D011446:Prospective Studies; D012189:Retrospective Studies