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Graft-Versus-Tumor Effects

Donor lymphocyte infusions can result in sustained remissions in patients with residual or relapsed lymphoid malignancy following allogeneic haemopoietic stem cell transplantation

Bone Marrow Transplantation volume 36, pages 437–441 (2005)Cite this article

Summary:

We treated 17 patients with refractory (n=7) or relapsed lymphoid malignancy (n=10) following allogeneic HSCT with donor lymphocyte infusions (DLI). Patients with low-grade disease received DLI alone (n=7) or following radiotherapy (n=1). Patients with aggressive disease (n=9) received prior chemotherapy. Nine out of 15 patients receiving DLI from sibling donors responded after one (n=6), two (n=2) and three (n=1) infusions. Both MUD recipients achieved CR after two and three DLI. In all, 10/17 patients achieved CR including 3/4 patients with chronic lymphatic leukaemia (CLL), 4/4 with mantle cell lymphoma (MCL), 3/4 with follicular NHL but 0/5 with aggressive NHL/Richters. The median CD3 cell dose to achieve CR for siblings was 2 × 107/kg. One patient with CLL had a second transplant following DLI-induced aplasia and is in CR at 14 months giving a final CR rate of 64%. Grade II–IV acute GVHD developed in 45% and chronic GVHD in 8/9 evaluable patients. Of the 11 patients finally achieving CR, one patient with MCL relapsed at 18 months post-DLI but all others remain in remission with a median follow-up of 40 months (range 12–64 months). Low-grade NHL and MCL have a high response rate and sustained remissions following DLI. Aggressive disease responds poorly however, despite pre-DLI chemotherapy.

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Authors and Affiliations

  1. Department of Haematology, Nottingham City Hospital, Nottingham, UK

    N H Russell, J L Byrne, R D Faulkner, M Gilyead, E P Das-Gupta & A P Haynes

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  1. N H Russell
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  2. J L Byrne
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  3. R D Faulkner
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  4. M Gilyead
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  5. E P Das-Gupta
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  6. A P Haynes
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Correspondence to E P Das-Gupta.

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Russell, N., Byrne, J., Faulkner, R. et al. Donor lymphocyte infusions can result in sustained remissions in patients with residual or relapsed lymphoid malignancy following allogeneic haemopoietic stem cell transplantation. Bone Marrow Transplant 36, 437–441 (2005). https://doi.org/10.1038/sj.bmt.1705074

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