PURPOSE: Treatment options for patients with chronic myeloid leukemia (CML) who relapse after allogeneic bone marrow transplantation (BMT) are limited. Treatment with lymphocytes from the original marrow donor and the influence on the malignant clone was studied in these patients. PATIENTS AND METHODS: Seven patients with CML that had relapsed after BMT with T-cell-depleted grafts were treated. Six patients received leukocyte infusions from the original marrow donor. One patient received a second BMT with unseparated marrow from the same sibling donor. Chimerism was studied using erythrocyte and cytogenetic markers. Residual leukemic cells were monitored by cytogenetic analysis of the Philadelphia (Ph) chromosome and by polymerase chain reaction (PCR) of the breakpoint cluster region/Abelson (BCR-ABL) fusion gene. RESULTS: In five patients with hematologic relapse, the Ph chromosome disappeared 1 to 3 months after the leukocyte infusions. Cytogenetic analysis and in situ hybridization (ISH) showed only donor cells during further follow-up. Four to five patients became negative for the BCR-ABL translocation by PCR. Graft-versus-host disease (GVHD) always preceded response and was severe in two patients. One patient with cytogenetic relapse showed no response after leukocyte infusions. GVHD after second BMT was of moderate severity. One year after second BMT, PCR for the BCR-ABL translocation was negative. CONCLUSION: Infusion of donor leukocytes is an effective treatment with a low mortality in patients with CML relapsed after BMT with a T-cell-depleted graft. Longer follow-up and more patients will be needed to know whether cure will be permanent.
PURPOSE: Treatment options for patients with chronic myeloid leukemia (CML) who relapse after allogeneic bone marrow transplantation (BMT) are limited. Treatment with lymphocytes from the original marrow donor and the influence on the malignant clone was studied in these patients. PATIENTS AND METHODS: Seven patients with CML that had relapsed after BMT with T-cell-depleted grafts were treated. Six patients received leukocyte infusions from the original marrow donor. One patient received a second BMT with unseparated marrow from the same sibling donor. Chimerism was studied using erythrocyte and cytogenetic markers. Residual leukemic cells were monitored by cytogenetic analysis of the Philadelphia (Ph) chromosome and by polymerase chain reaction (PCR) of the breakpoint cluster region/Abelson (BCR-ABL) fusion gene. RESULTS: In five patients with hematologic relapse, the Ph chromosome disappeared 1 to 3 months after the leukocyte infusions. Cytogenetic analysis and in situ hybridization (ISH) showed only donor cells during further follow-up. Four to five patients became negative for the BCR-ABL translocation by PCR. Graft-versus-host disease (GVHD) always preceded response and was severe in two patients. One patient with cytogenetic relapse showed no response after leukocyte infusions. GVHD after second BMT was of moderate severity. One year after second BMT, PCR for the BCR-ABL translocation was negative. CONCLUSION: Infusion of donor leukocytes is an effective treatment with a low mortality in patients with CML relapsed after BMT with a T-cell-depleted graft. Longer follow-up and more patients will be needed to know whether cure will be permanent.
Authors: Lori Muffly; Kevin Sheehan; Randall Armstrong; Kent Jensen; Keri Tate; Andrew R Rezvani; David Miklos; Sally Arai; Judith Shizuru; Laura Johnston; Everett Meyer; Wen-Kai Weng; Ginna G Laport; Robert S Negrin; Sam Strober; Robert Lowsky Journal: Blood Adv Date: 2018-03-27
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Authors: Renier J Brentjens; Isabelle Rivière; Jae H Park; Marco L Davila; Xiuyan Wang; Jolanta Stefanski; Clare Taylor; Raymond Yeh; Shirley Bartido; Oriana Borquez-Ojeda; Malgorzata Olszewska; Yvette Bernal; Hollie Pegram; Mark Przybylowski; Daniel Hollyman; Yelena Usachenko; Domenick Pirraglia; James Hosey; Elmer Santos; Elizabeth Halton; Peter Maslak; David Scheinberg; Joseph Jurcic; Mark Heaney; Glenn Heller; Mark Frattini; Michel Sadelain Journal: Blood Date: 2011-08-17 Impact factor: 22.113
Authors: J Michalek; R H Collins; H P Durrani; P Vaclavkova; L E Ruff; D C Douek; E S Vitetta Journal: Proc Natl Acad Sci U S A Date: 2003-01-16 Impact factor: 11.205
Authors: Yves Chalandon; Jakob R Passweg; Cesare Guglielmi; Simona Iacobelli; Jane Apperley; Nicolaas P M Schaap; Jürgen Finke; Marie Robin; Roberta Fedele; Dominique Bron; Ibrahim Yakoub-Agha; Anja van Biezen; Theo de Witte; Nicolaus Kröger; Eduardo Olavarria Journal: Haematologica Date: 2014-07-04 Impact factor: 9.941
Authors: P A Holloway; N Kaldenhoven; H M Kok-Schoemaker; B Van Kessel; W T M Van Blokland; A C Bloem; H M Lokhorst Journal: Clin Exp Immunol Date: 2003-02 Impact factor: 4.330