title: Donor Lymphocyte Infusion for Relapsed Hematological Malignancies after Unrelated Allogeneic Bone Marrow Transplantation Facilitated by the Japan Marrow Donor Program.
abstract: To evaluate the safety and efficacy of donor lymphocyte infusion (DLI), we retrospectively analyzed 414 recipients who received unrelated DLI (UDLI) for the treatment of relapsed hematological malignancy after unrelated bone marrow transplantation (BMT). UDLI was administered for acute myelogenous leukemia (n = 184), myelodysplastic syndrome (n = 69), acute lymphocytic leukemia (n = 57), chronic myelogenous leukemia (CML, n = 36), lymphoid neoplasms (n = 38), adult T cell leukemia/lymphoma (n = 18), and multiple myeloma (n = 12). Sixty-five patients (16%) were in cytogenetic/molecular relapse and 349 (84%) were in hematological relapse after BMT. In total, 266 out of 414 (64%) patients received chemotherapy and/or molecular-targeted agents in combination with UDLI. The median time from BMT to UDLI was 244 days. The median number of infused CD3+cells was 3.51 × 107/kg. Response and survival rates were evaluated at 100 days after UDLI. Complete response was obtained in 37 (57%) of 65 patients with cytogenetic/molecular relapse and in 69 (20%) of 349 patients with hematological relapse (P < .001). Two hundred forty-seven patients (60%) were alive, whereas 110 (26%) had died because of disease progression, 26 (6%) because of infections, 12 (3%) because of graft-versus-host disease (GVHD), and 13 (3%) because of organ failure. Multivariate analysis identified molecular/cytogenetic relapse, GVHD after UDLI, and CML but not combination with chemotherapy as significant prognostic factors. These results indicate that UDLI may have efficacy in relapsed patients with CML, low tumor burden, or occurrence of GVHD after UDLI.
authors.affiliation: Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan. Electronic address: toshmiya@intmed1.med.kyushu-u.ac.jp.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Miyamoto
authors.affiliation: Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors.forename: Marie
authors.initials: M
authors.lastname: Nakashima
authors.affiliation: Center for Cellular and Molecular Medicine, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Henzan
authors.affiliation: Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kusakabe
authors.affiliation: Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kobayashi
authors.affiliation: Department of Hematology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Sugita
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mori
authors.affiliation: Department of Cell Therapy and Transplantation Medicine, Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Mineo
authors.initials: M
authors.lastname: Kurokawa
authors.affiliation: Hematology and Oncology Division, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Shin-Ichiro
authors.initials: SI
authors.lastname: Mori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation / Q000379:methods*; D017252:CD3 Complex / Q000032:analysis; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007223:Infant; D007564:Japan; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive; D017710:Lymphocyte Transfusion / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012074:Remission Induction; D016019:Survival Analysis; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D061349:Unrelated Donors; D055815:Young Adult
chemical_list: D017252:CD3 Complex
keywords: Allogeneic; Bone marrow transplantation; Donor lymphocyte infusion; Relapse; Unrelated