title: An improved anti-leukemic effect achieved with donor progenitor cell infusion for relapse patients after allogeneic bone marrow transplantation.
abstract: OBJECTIVE
  To observe the antileukemic effect in relapse patients by infusion of donor immunocompetent cells with or without granulocyte colony-stimulating factor (G-CSF) mobilization.
  
  
  METHODS
  Twenty patients with leukemia in relapse after allogeneic bone marrow transplantation (allo-BMT) were treated with chemotherapy followed by donor-derived lymphocytes (DDL) without G-CSF mobilization (Group A, n = 11), or donor peripheral blood progenitor cells (PBPCs) with G-CSF mobilization (Group B, n = 9).
  
  
  RESULTS
  Five patients in Group A were in hematologic relapse. After DDL infusion, 3 of 5 patients had a temporary complete remission (CR) and relapsed after 3, 7 and 10 months, respectively. One achieved partial remission and died of interstitial pneumonia; and the other one showed no response. Another 6 patients in Group A were in cytogenetic relapse or central nerve system (CNS) leukemia, and all achieved CR and remained in disease free survival (DFS) for 10 to 98 months after DDL infusion. All 9 patients in group B were in hematologic relapse. Three patients with chronic myeloid leukemia (CML) had cytogenetic and molecular remission for 16, 35 and 51 months, respectively after PBPC infusion; and 5 patients with acute lymphoid leukemia (ALL) had CR and were still in CR for 10 to 18 months except 1 patient relapsed soon. And the other one with AML showed no response to the therapy.
  
  
  CONCLUSIONS
  Donor immunocompetent cells infusion is an effective therapy for relapsed leukemia after allo-BMT, especially for the patients with early (molecular and cytogenetic) or CNS relapse. Infusion of donor PBPC mobilized by G-CSF seems to have more potentiated graft-versus-leukemia (GVL) effect than DDL infusion.
authors.affiliation: Institute of Hematology, People's Hospital, Peking University, Beijing 100044, China. xjhrm@cenpok.net
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Huang
authors.forename: Nailan
authors.initials: N
authors.lastname: Guo
authors.forename: Hanyun
authors.initials: H
authors.lastname: Ren
authors.forename: Yaochen
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Gao
authors.forename: Daopei
authors.initials: D
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence
chemical_list: D016179:Granulocyte Colony-Stimulating Factor