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Donor Lymphocyte Infusions

Adoptive immunotherapy with donor lymphocyte infusions and interleukin-2 after high-dose therapy and autologous stem cell rescue for multiple myeloma

Bone Marrow Transplantation volume 34, pages 419–423 (2004)Cite this article

Summary:

In an attempt to induce a graft-versus-myeloma effect, we administered donor lymphocyte infusions (DLI) after high-dose therapy with autologous stem cell transplant rescue to seven patients with refractory or relapsed multiple myeloma. High-dose therapy consisted of melphalan, idarubicin and etoposide (days –9 to –6) followed by autologous stem cell infusion on day 0. DLI (five of seven donors with two or three HLA antigens mismatched) were administered on days +1, +5 and +10 along with IL-2 (from day +1 through +12). Six of the seven patients developed acute graft-versus-host disease (GVHD), which resolved spontaneously, coincidentally with autologous hematopoietic reconstitution. One patient failed to engraft and received a second autologous graft. One patient died from complications of a pulmonary hemorrhage after experiencing GVHD. With a minimum follow-up of 38 months, five patients remain without disease progression in complete remission or with minimal residual disease. In this setting, DLI/IL-2 is biologically active resulting in GVHD. A graft-versus-myeloma effect is suggested by the improved outcome of our small cohort of high-risk patients. The use of partially mismatched related donors makes this approach potentially available to nearly all patients.

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Authors and Affiliations

  1. Stem Cell Transplant Program, Medical College of Georgia, Augusta, GA, USA

    O F Ballester, G Ballester & J Hiemenz

  2. Bone Marrow Transplant Program, Midwestern Regional Medical Center, Zion, IL, USA

    O F Ballester, T Fang, A Raptis, G Ballester, P Wilcox & B Tan

Authors
  1. O F Ballester
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  2. T Fang
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  3. A Raptis
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  4. G Ballester
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  5. P Wilcox
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  6. J Hiemenz
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  7. B Tan
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Correspondence to O F Ballester.

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Ballester, O., Fang, T., Raptis, A. et al. Adoptive immunotherapy with donor lymphocyte infusions and interleukin-2 after high-dose therapy and autologous stem cell rescue for multiple myeloma. Bone Marrow Transplant 34, 419–423 (2004). https://doi.org/10.1038/sj.bmt.1704617

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  • DOI: https://doi.org/10.1038/sj.bmt.1704617

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