INTRODUCTION: High relapse rates and infections remain primary causes of failure in nonmyeloablative transplantation. Interleukin-2 (IL-2) may stimulate the immune system and improve outcomes. The primary objective of this pilot study was to evaluate the feasibility of administering IL-2 following a T-cell-depleted nonmyeloablative hematopoietic stem cell transplant. METHODS: Patients received T-cell-depleted nonmyeloablative transplant from a matched or mismatched related donor. Those with allogeneic engraftment, <grade 2 acute GVHD at time of study entry, and no severe end organ damage were eligible and received IL-2 starting 6 weeks after the first day of stem cell infusion. Patients received 1 mu/m2 daily for 5 days each week for 4 weeks followed by a 2-week rest period for a 6-week cycle to continue for up to 1 year. RESULTS: Eight patients aged 28-69 years were treated. Significant toxicities were limited to GVHD of the skin ≤grade 2 in 3 patients and severe fatigue in 4 patients, limiting the duration of therapy. Two of the 8 patients died of relapsed disease and 1 from CMV. With a median overall duration of follow-up of survivors of 48 months, 5 patients (63%) remain alive and in continuous complete remission.
INTRODUCTION: High relapse rates and infections remain primary causes of failure in nonmyeloablative transplantation. Interleukin-2 (IL-2) may stimulate the immune system and improve outcomes. The primary objective of this pilot study was to evaluate the feasibility of administering IL-2 following a T-cell-depleted nonmyeloablative hematopoietic stem cell transplant. METHODS:Patients received T-cell-depleted nonmyeloablative transplant from a matched or mismatched related donor. Those with allogeneic engraftment, <grade 2 acute GVHD at time of study entry, and no severe end organ damage were eligible and received IL-2 starting 6 weeks after the first day of stem cell infusion. Patients received 1 mu/m2 daily for 5 days each week for 4 weeks followed by a 2-week rest period for a 6-week cycle to continue for up to 1 year. RESULTS: Eight patients aged 28-69 years were treated. Significant toxicities were limited to GVHD of the skin ≤grade 2 in 3 patients and severe fatigue in 4 patients, limiting the duration of therapy. Two of the 8 patients died of relapsed disease and 1 from CMV. With a median overall duration of follow-up of survivors of 48 months, 5 patients (63%) remain alive and in continuous complete remission.
Authors: H E Heslop; D J Gottlieb; A C Bianchi; A Meager; H G Prentice; A B Mehta; A V Hoffbrand; M K Brenner Journal: Blood Date: 1989-09 Impact factor: 22.113
Authors: L J Burns; D J Weisdorf; T E DeFor; D H Vesole; T L Repka; B R Blazar; S R Burger; A Panoskaltsis-Mortari; C A Keever-Taylor; M-J Zhang; J S Miller Journal: Bone Marrow Transplant Date: 2003-07 Impact factor: 5.483
Authors: L F Odom; C S August; J H Githens; J R Humbert; H Morse; D Peakman; B Sharma; S L Rusnak; F B Johnson Journal: Lancet Date: 1978-09-09 Impact factor: 79.321
Authors: K M Sullivan; P L Weiden; R Storb; R P Witherspoon; A Fefer; L Fisher; C D Buckner; C Anasetti; F R Appelbaum; C Badger Journal: Blood Date: 1989-05-01 Impact factor: 22.113
Authors: John Koreth; Ken-ichi Matsuoka; Haesook T Kim; Sean M McDonough; Bhavjot Bindra; Edwin P Alyea; Philippe Armand; Corey Cutler; Vincent T Ho; Nathaniel S Treister; Don C Bienfang; Sashank Prasad; Dmitrios Tzachanis; Robin M Joyce; David E Avigan; Joseph H Antin; Jerome Ritz; Robert J Soiffer Journal: N Engl J Med Date: 2011-12-01 Impact factor: 91.245