1. ¹Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
2. ²Unit of Bone Marrow Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany
3. ³Department of Hematology/Oncology, Clinic of Internal Medicine, University of Heidelberg, Heidelberg, Germany
4. ⁴Department of Hematology and Bone Marrow Transplantation, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy
5. ⁵Servicio de Hematologia, Hospital Clinico Universitario de Salamanca, Salamanca, Spain
6. ⁶Department of Hematology, Erasmus MC, Rotterdam, The Netherlands
7. ⁷Department of Hematology, University Medical Center Nijmegen, St Radboud University, Nijmegen, The Netherlands
8. ⁸Department of Hematology, Academic Medical Center, Amsterdam, The Netherlands
9. ⁹Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel

Correspondence: Dr HM Lokhorst, Department of Hematology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. E-mail: h.lokhorst@umcutrecht.nl

Received 18 January 2006; Revised 3 April 2006; Accepted 5 April 2006.

Abstract

In this retrospective study, we evaluated donor lymphocyte infusions given for relapsed (n=48) or persistent (n=15) myeloma following non-myeloablative allogeneic stem cell transplantation (Allo-SCT). Twenty-four of 63 patients (38.1%) responded: 12 patients (19.0%) with a partial response (PR) and 12 patients (19.0%) with a complete response (CR). Overall survival after donor lymphocyte infusions (DLI) was 23.6 months (1.0–50.7+). Median overall survival for non-responding patients was 23.6 months and has not been reached for the patients responding to DLI. In responders, progression-free survival after DLI was 27.8 months (1.2–46.2+). Patients with a PR had a median progression-free survival of 7.0 months, whereas patients with a CR to DLI had a median progression-free survival of 27.8 months. Major toxicities were acute graft-versus-host disease (GVHD) (38.1%) and chronic GVHD (42.9%). Seven patients (11.1%) died from treatment-related mortality. The only significant prognostic factors for response to DLI were the occurrence of acute and chronic GVHD. There was a trend towards significance for time between transplantation and DLI, and response. Donor lymphocyte infusion following non-myeloablative Allo-SCT is a valuable strategy for relapsed or persistent disease.