1. ¹Division of Clinical Research, Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, WA, USA
2. ²Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, WA, USA
3. ³Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
4. ⁴Department of Biostatistics, University of Washington School of Medicine, Seattle, WA, USA

Correspondence: Dr MED Flowers, Fred Hutchinson Cancer Research Center (FHCRC), 1100 Fairview Avenue N, D5-290, Seattle, WA 98109-1024, USA. E-mail: mflowers@fhcrc.org

Received 11 May 2007; Revised 28 June 2007; Accepted 6 July 2007; Published online 10 September 2007.

Abstract

Allogeneic hematopoietic cell transplantation (HCT) represents a potentially curative approach for patients with myelodysplastic syndromes (MDSs). While a large proportion of HCT recipients become long-term disease-free survivors, recurrence of MDS remains the leading cause of mortality after HCT. The role of donor lymphocyte infusion (DLI) in patients with relapsed MDS after HCT is unclear. We report results among 16 patients treated with DLI for relapsed MDS after HCT at a single institution between March 1993 and February 2004. The cohort contained 10 men and 6 women with a median age of 49 (range, 22–67) years. CR with resolution of cytopenias and prior disease markers occurred in 3 of 14 patients who could be evaluated. Two patients survived without MDS for 68 and 65 months after DLI, respectively, but died with pneumonia. Grades II–IV acute GVHD and chronic GVHD occurred after DLI in 6 (43%) and 5 (36%) patients, respectively. All three responders developed grades III–IV acute GVHD and extensive chronic GVHD after DLI. Our results confirm prior reports that DLI can result in CR in some patients with recurrent MDS after transplant, but long-term survival is infrequent.