title: Donor lymphocyte infusions for the treatment of chronic myeloid leukemia relapse following peripheral blood or bone marrow stem cell transplantation.
abstract: Peripheral blood used as a source of stem cells for transplantation (PBSCT) is known to exert stronger immune-mediated effects compared with BM (BMT). We decided to retrospectively analyze the impact of stem cell source on the OS of CML patients who relapsed after either matched related donor PBSCT (N=168) or BMT (N=216) and were treated with donor lymphocyte infusions (DLI). Univariate analysis revealed a lower probability of OS after DLI in patients relapsing after PBSCT vs BMT (66% vs 79% at 5 years, P=0.013). However, a multivariate Cox analysis did not reveal any significant impact of PBSCT as a risk factor for decreased OS for patients transplanted in first chronic phase (CP1; hazard ratio (HR) 1.036, 95% confidence interval (CI) 0.619-1.734). A statistical interaction term suggested that the impact of stem cell source on OS after DLI was different for those transplanted in advanced phases (negative impact of previous PBSCT-HR 2.176, 95% CI 0.930-5.091). In summary, the stem cell source does not affect the OS of CML patients who underwent PBSCT in CP1, relapsed and were treated with DLI. However, when the patients were transplanted in advanced phases, previous PBSCT seems to negatively affect OS after DLI compared with BMT.
authors.affiliation: Department of Hematology, Oncology and Internal Diseases, The Medical University of Warsaw, Warsaw, Poland. gbasak@ib.amwaw.edu.pl
authors.forename: G W
authors.initials: GW
authors.lastname: Basak
authors.forename: L C
authors.initials: LC
authors.lastname: de Wreede
authors.forename: A
authors.initials: A
authors.lastname: van Biezen
authors.forename: W
authors.initials: W
authors.lastname: Wiktor-Jedrzejczak
authors.forename: K
authors.initials: K
authors.lastname: Halaburda
authors.forename: C
authors.initials: C
authors.lastname: Schmid
authors.forename: N
authors.initials: N
authors.lastname: Schaap
authors.forename: F
authors.initials: F
authors.lastname: Dazzi
authors.forename: P A
authors.initials: PA
authors.lastname: von dem Borne
authors.forename: E
authors.initials: E
authors.lastname: Petersen
authors.forename: D
authors.initials: D
authors.lastname: Beelen
authors.forename: A
authors.initials: A
authors.lastname: Abayomi
authors.forename: L
authors.initials: L
authors.lastname: Volin
authors.forename: A
authors.initials: A
authors.lastname: Buzyn
authors.forename: G
authors.initials: G
authors.lastname: Gurman
authors.forename: D
authors.initials: D
authors.lastname: Bunjes
authors.forename: C
authors.initials: C
authors.lastname: Guglielmi
authors.forename: E
authors.initials: E
authors.lastname: Olavarria
authors.forename: T
authors.initials: T
authors.lastname: de Witte
mesh_terms: D000328:Adult; D064591:Allografts; D016026:Bone Marrow Transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality / Q000517:prevention & control*; D017710:Lymphocyte Transfusion; D036102:Peripheral Blood Stem Cell Transplantation; D012008:Recurrence; D012189:Retrospective Studies; D014019:Tissue Donors