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| Donor Lymphocyte Infusions |
| Donor leukocyte infusions in acute lymphocytic leukemia |
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| R H Collins Jr1,2, S Goldstein3, S Giralt4, J Levine5, D Porter6, W Drobyski7, J Barrett8, M Johnson2, A Kirk2, M Horowitz7,9 and P Parker10 |
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1University of Texas Southwestern Medical Center, Dallas, TX, USA
2Baylor Sammons Cancer Center, Dallas, TX, USA
3H Lee Moffitt Cancer Center, Tampa, FL, USA
4University of Texas MD Anderson Cancer Center, Houston, TX, USA
5University of Michigan, Ann Arbor, MI, USA
6University of Pennsylvania School of Medicine, PA, USA
7Medical College of Wisconsin, Milwaukee, WI, USA
8National Heart Lung and Blood Institute, Bethesda, MD, USA
9International Bone Marrow Transplant Registry, Milwaukee, WI, USA
10City of Hope, Duarte, CA, USA
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Correspondence to: Dr RH Collins Jr, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8590, USA
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| Abstract |
| Donor leukocyte infusion (DLI) has well-documented activity in CML but the role of DLI in other diseases is less well defined. To evaluate the strategy in acute lymphocytic leukemia (ALL) we evaluated 44 ALL patients from 27 centers who were treated with DLI. Patients with persistent or recurrent disease received DLI from the original marrow donor (30 matched related, four mismatched family, and 10 matched unrelated). Chemotherapy was given before DLI to 28 patients. Of 15 patients who received no pre-DLI chemotherapy, two achieved complete remissions, lasting 1112 and 764+ days. In four patients who received DLI as consolidation of remission induced by chemotherapy or immunosuppression-withdrawal, duration of remission post DLI was 65, 99, 195 and 672+ days. Of 25 patients who received DLI in the nadir after chemotherapy, 13 survived  30 days post DLI but did not achieve remission, seven died within less than 30 days post DLI, and five entered remissions that lasted 42, 68, 83, 90, 193 days. Seven patients who did not respond to the initial DLI received a second DLI; none of these patients attained durable remission. Eighteen of 37 evaluable patients developed acute GVHD and five of 20 evaluable patients developed chronic GVHD. Overall actuarial survival is 13% at 3 years. In conclusion, DLI has limited benefit in ALL. New approaches are needed in this group of patients. Bone Marrow Transplantation (2000) 26, 511-516. |
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| Keywords |
| acute lymphocytic leukemia; donor leukocyte infusions; adoptive immunotherapy |
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| Received 22 February 2000; accepted 28 April 2000 |
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| September 2000, Volume 26, Number 5, Pages 511-516 |
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