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| Donor Lymphocyte Infusion |
| Prophylactic T cell infusion after T cell-depleted bone marrow transplantation in patients with refractory lymphoma |
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| C-K Lee1, M de Magalhaes-Silverman1, R J Hohl1, M Hayashi1, J Buatti2, B C Wen5, A Schlueter3, R G Strauss4 and R D Gingrich1 |
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1Department of Internal Medicine, Division of Hematology, Oncology, Blood and Marrow Transplantation, University of Iowa, College of Medicine, Iowa City, IA, USA
2Division of Radiation Oncology, Department of Radiology, University of Iowa, College of Medicine, Iowa City, IA, USA
3Department of Pathology, University of Iowa, College of Medicine, Iowa City, IA, USA
4Department of Pathology and Pediatrics, University of Iowa, College of Medicine, Iowa City, IA, USA
5Department of Radiation Oncology, University of Miami, Miami, FL, USA
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Correspondence to: Dr C-K Lee, Myeloma and Transplant Research Center, University of Arkansas for Medical Sciences, Slot 776, 4301 West Markham, Little Rock, Arkansas 72205, USA |
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| Abstract |
| Fifty-two patients with refractory lymphoma were prospectively treated with prophylactic T lymphocyte infusion after T cell-depleted allogeneic bone marrow transplantation, to induce graft-versus-lymphoma effect. Thirty-three patients had related donors; 19 had unrelated donors. After transplantation with marrow that had 0.8 ± 0.4 ´ 105CD3+ cells/kg, T cells up to 1.75 ´ 106 CD3+ cells/kg were given over 3 months provided  grade II acute graft-versus-host disease (GVHD) was not seen. The cumulative incidence of grades II-IV acute GVHD was 69%. Twenty of 32 evaluable patients (63%) developed chronic GVHD. Ten patients (19%) died of GVHD. The Kaplan-Meier 5-year overall survival of all patients was 34%. On multivariate analyses, chronic GVHD was significant for relapse (hazard ratio of 1.7, P < 0.05), and for overall survival (hazard ratio 1.4, P < 0.001). Chemosensitivity was significant for relapse only on univariate analysis. Patients who developed chronic GVHD had 4 years median survival, compared with 9 months in patients without chronic GVHD, P < 0.001. The study shows that patients with chronic GVHD have superior survivals, most probably related to a graft-versus-lymphoma effect, which could be modulated by prophylactic T cell infusion. Bone Marrow Transplantation (2002) 29, 615-620. DOI: 10.1038/sj/bmt/1703426 |
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| Keywords |
| graft-versus-lymphoma effect; DLI; refractory lymphoma |
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| Received 30 August 2001; accepted 9 January 2002 |
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| April (1) 2002, Volume 29, Number 7, Pages 615-620 |
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