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Autografting

Results of donor lymphocyte infusions for relapsed myelodysplastic syndrome after hematopoietic cell transplantation

Bone Marrow Transplantation volume 40, pages 965–971 (2007)Cite this article

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.

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Acknowledgements

We thank the staff of the Long-Term Follow-Up for invaluable assistance with data collection, and Helen Crawford and Bonnie Larson for typing the article. We are also very grateful to our patients for their participation in clinical trials and our attending and medical staff for their excellent care provided to patients and families. Supported in part by grants CA78902, CA18029, CA15704, CA106512, HL82941 and HL36444, from the NIH, DHHS, Bethesda, MD, USA.

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Authors and Affiliations

  1. Division of Clinical Research, Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, WA, USA

    P V Campregher, T Gooley, B L Scott, C Moravec, B Sandmaier, P J Martin, H J Deeg, E H Warren & M E D Flowers

  2. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, WA, USA

    T Gooley

  3. Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA

    T Gooley

  4. Department of Biostatistics, University of Washington School of Medicine, Seattle, WA, USA

    B Sandmaier, P J Martin, H J Deeg & M E D Flowers

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  1. P V Campregher
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Correspondence to M E D Flowers.

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Campregher, P., Gooley, T., Scott, B. et al. Results of donor lymphocyte infusions for relapsed myelodysplastic syndrome after hematopoietic cell transplantation. Bone Marrow Transplant 40, 965–971 (2007). https://doi.org/10.1038/sj.bmt.1705840

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