title: Induction of graft versus malignancy effect after unrelated allogeneic PBSCT using donor lymphocyte infusions derived from frozen aliquots of the original graft.
abstract: To evaluate safety and efficacy of donor lymphocyte infusions (DLI), derived from frozen aliquots of the original G-CSF-stimulated graft after allogeneic PBSCT from unrelated donors, data of 121 patients with hematological malignancies treated with DLIs were retrospectively analyzed. Indications for PBSCT were AML/myelodysplastic syndrome (n=63/8), ALL (n=17), lymphoma (n=13), multiple myeloma (n=10) and myeloproliferative syndrome (n=10). Reasons for DLI were hematological relapse (n=81), molecular and/or cytogenetic relapse (n=5), mixed chimerism (n=22) and prophylactic DLI in high-risk patients (n=13). DLIs were well tolerated with no acute adverse reactions. DLI-induced acute-type GvHD (aGvHD) was observed in 19 patients and chronic-type GvHD (cGvHD) developed in 14 patients. Three patients died of GvHD complications. DLI induced CR, complete chimerism or PR in 34 patients; 24 patients had stable disease, 50 patients progressed and 13 patients were not evaluable for response. Objective response was more obvious for molecular relapse (5/5) or mixed chimerism (14/22) compared with hematological relapse (13/81). Median survival after first DLI was 10.4 months (95% confidence interval: 4.4-26.0). Cryopreserved G-CSF-stimulated DLI, derived from allogeneic grafts are safe and immunoreactive, and can be applied early in case of mixed chimerism and molecular or cytogenetic relapse.
authors: Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany.
authors: J
authors: J
authors: Hasskarl
authors: A
authors: A
authors: Zerweck
authors: R
authors: R
authors: Wäsch
authors: G
authors: G
authors: Ihorst
authors: H
authors: H
authors: Bertz
authors: J
authors: J
authors: Finke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001793:Blood Preservation; D015925:Cryopreservation; D005260:Female; D020544:Graft vs Leukemia Effect; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D019337:Hematologic Neoplasms / Q000097:blood / Q000276:immunology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D017710:Lymphocyte Transfusion / Q000009:adverse effects / Q000379:methods*; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D061349:Unrelated Donors; D055815:Young Adult
chemical_list: D016179:Granulocyte Colony-Stimulating Factor