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Graft-Versus-Host Disease

Outcome of patients developing GVHD after DLI given to treat CML relapse: a study by the chronic leukemia working party of the EBMT

Bone Marrow Transplantation volume 45, pages 558–564 (2010)Cite this article

Abstract

We studied GVHD after donor lymphocyte infusion (DLI) in 328 patients with relapsed CML between 1991 and 2004 . A total of 122 patients (38%) developed some form of GVHD. We analyzed GVHD by clinical presentation (acute or chronic GVHD) and onset time after the first DLI (early (⩽45 days) or late (>45 days)). There was a significant overlap between onset time and clinical presentation. Some form of GVHD occurred at a median of 104 days, acute GVHD at 45 days and chronic GVHD at 181 days after DLI. The clinical presentation was acute GVHD in 71 patients, of whom 31 subsequently developed chronic GVHD subsequently. De novo chronic GVHD was seen in 51 patients. OS for all patients was 69% (95% confidence interval (CI) 63–75) at 5 years, DLI-related mortality was 11% (95% CI 8–15) and disease-related mortality was 20% (95% CI 16–25). Risk factors for developing GVHD after DLI were T-cell dose at first DLI, the time interval from transplant to DLI and donor type. In time-dependent multivariate analysis, GVHD after DLI was associated with a risk of death of 2.3-fold compared with patients without GVHD. Clinical presentation as acute GVHD and early onset GVHD were associated with increased mortality.

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Author information

Authors and Affiliations

  1. Division of Hematology, Department of Internal Medicine, University Hospital, Geneva, Switzerland

    Y Chalandon & J R Passweg

  2. Klinikum Augsburg II Medizinische Klinik, Augsburg, Germany

    C Schmid

  3. Department of Haematology, Imperial College, Hammersmith Hospital, London, UK

    E Olavarria, F Dazzi & M P Simula

  4. Huddinge Haematology Centre, Karolinska University Hospital, Huddinge, Sweden

    P Ljungman

  5. Department of Hematology, Radboud University—Nijmegen Medical Centre, Nijmegen, The Netherlands

    A Schattenberg & T de Witte

  6. Department of Hematology, University Hospital, Lund, Sweden

    S Lenhoff

  7. Department of Haematology and BMT Unit, Constantiaberg Medi-Clinic, Searl Lab for Cellular & Molecular Biology, Cape Town, South Africa

    P Jacobs

  8. Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland

    L Volin

  9. Dipartimento Scienze per la Salute, University of Molise, Rome, Italy

    S Iacobelli

  10. Department of Medical Statistics & Bioinformatics, Chronic Leukaemia WP Registry, Leiden, The Netherlands

    S Iacobelli

  11. Department of Medicine—Hematology, Oncology, University of Freiburg, Freiburg, Germany

    J Finke

  12. Division of Haematology & Oncology, University of Leipzig, Leipzig, Germany

    D Niederwieser

  13. Universita ′La Sapienzá, Il Facolta di Medicina, UOC Ematologia AOS Andrea, Rome, Italy

    C Guglielmi

Authors
  1. Y Chalandon
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  2. J R Passweg
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  3. C Schmid
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  4. E Olavarria
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  5. F Dazzi
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  6. M P Simula
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  7. P Ljungman
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  8. A Schattenberg
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  9. T de Witte
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  10. S Lenhoff
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  11. P Jacobs
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  12. L Volin
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  13. S Iacobelli
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  14. J Finke
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  15. D Niederwieser
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  16. C Guglielmi
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on behalf of the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT)

Corresponding author

Correspondence to Y Chalandon.

Appendix 1

Appendix 1

EBMT centers (center number)

E Olavarria, Hammersmith Hospital, London, UK (205)

A Schattenberg, University Medical Centre St Radboud, Nijmegen, The Netherlands (237)

P Jacobs, Constantiaberg Med-Clin, Cape Town, South Africa (772)

P Ljungman, Huddinge University Hospital, Huddinge, Sweden (212)

J Finke, University Hospital Freiburg, Freiburg, Germany (810)

S Lenhoff, University Hospital, Lund, Sweden (283)

L Volin, Helsinki University Central Hospital, Helsinki, Finland (515)

N Jacobsen, Rigshospitalet, Copenhagen, Denmark (206)

J Passweg, Hopital Cantonal Universitaire, Geneva, Switzerland (261)

JP Jouet, Hopital Claude Huriez, Lille, France (277)

CA de Souza, Univ. Est. de Campinas/TMO/UNICAMP, Campinas SP, Brazil (374)

M. Michallet, Hopital E Herriot, Lyon, France (671)

A Ferrant, Cliniques Universitaires St Luc, Brussels, Belgium (234)

JL Harousseau, Hotel Dieu, Nantes, France (253)

D Milligan, Birmingham Heartlands Hospital, Birmingham, UK (284)

E Liakopoulou, Christie NHS Trust Hospital, Manchester, United Kingdom (780)

D Bron, Institut Jules Bordet, Brussels, Belgium (215)

R Hamladji, Centre Pierre et Marie Curie, Alger, Algeria (703)

V Koza, Charles University Hospital, Pilsen, Czech Republic (718)

B Bandini, Hospital San Orsola, Bologna, Italy (240)

V Leblond, Pitie-Salpetriere, Paris, France (262)

R Haas, Heinrich Heine Universität, Düsseldorf,Germany (390)

Y Beguin, University of Liege, Liege, Belgium (726)

G Mufti, GKT School of Medicine London, United Kingdom (763)

M Bornhäuser, Universitätsklinikum Dresden, Dresden, Germany (808)

M Boogaerts, University Hospital of Leuven, Leuven, Belgium (209)

JM Davies, Western General Hospital, Edinburgh, Scotland, UK (228)

J Sierra, Hospital Santa Creu I Sant Pau, Barcelona, Spain (260)

U Pihkala, University of Helsinki, Hospital for Children & Adolescents, Helsinki, Finland (219)

A Zander, University Hospital Eppendorf, Hamburg, Germany (614)

J Pretnar, University Medical Center, Ljubljana, Slovenia (640)

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Chalandon, Y., Passweg, J., Schmid, C. et al. Outcome of patients developing GVHD after DLI given to treat CML relapse: a study by the chronic leukemia working party of the EBMT. Bone Marrow Transplant 45, 558–564 (2010). https://doi.org/10.1038/bmt.2009.177

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