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Allografting

Long term disease-free survival in acute leukemia patients recovering with increased γδ T cells after partially mismatched related donor bone marrow transplantation

Bone Marrow Transplantation volume 39, pages 751–757 (2007)Cite this article

Abstract

Allogeneic stem cell transplantation (ASCT) has improved leukemia-free survival (LFS) in many but not all patients with acute leukemia. This is an eight-year follow-up to our previous study showing a survival advantage to patients with an increased γδ T cells following ASCT. γδ T cell levels were collected prospectively in 153 patients (acute lymphoblastic leukemia (ALL) n=77; acute myelogenous leukemia (AML) n=76) undergoing partially mismatched related donor ASCT. Median age was 22 years (1–59), and 62% of the patients were in relapse at transplant. Patient–donor human leukocyte antigen (HLA) disparity of three antigens was 37% in the graft-versus-host disease (GvHD) and 29% in the rejection directions. All patients received a partially T cell-depleted graft using T10B9 (n=46) or OKT3 (n=107). Five years LFS and overall survival (OS) of patients with increased γδ compared to those with normal/decreased numbers were 54.4 vs 19.1%; P<0.0003, and 70.8 vs 19.6% P<0.0001, respectively, with no difference in GvHD (P=0.96). In a Cox multivariate analysis, normal/decreased γδ (hazard ratio (HR) 4.26, P=0.0002) and sex mismatch (HR 1.45 P=0.049) were associated with inferior LFS. In conclusion, γδ T cells may facilitate a graft-versus-leukemia (GvL) effect, without causing GvHD. Further evaluations of this effect may lead to specific immunotherapy for patients with refractory leukemia.

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Acknowledgements

This study was supported by NIH NCI R21 CA 76667 and Leukemia and Lymphoma Society 6507. The study was presented in part at the ASH meeting 2002 and ASCO meeting 2003.

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Authors and Affiliations

  1. South Carolina Cancer Center, Columbia, SC, USA

    K T Godder, P J Henslee-Downey, J Mehta, K-Y Chiang, S Abhyankar & L S Lamb

  2. Pediatric Hematology/Oncology, Children's Medical Center, VCU Health Systems/MCV Hospitals and Physicians, Richmond, VA, USA

    K T Godder

  3. The Robert H Lurie Comprehensive Cancer Center, North Western University, Chicago, IL, USA

    J Mehta

  4. Biostatistics Shared Resource, Cancer Institute, Oregon Health and Science University, Portland, OR, USA

    B S Park

  5. Aflac Cancer Center, Children's Health/Care of Atlanta at Emory University, Atlanta, GA, USA

    K-Y Chiang

  6. Kansas City BMT Program, Kansas City, KS, USA

    S Abhyankar

  7. University of Alabama at Birmingham, Birmingham, AL, USA

    L S Lamb

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Correspondence to K T Godder.

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Godder, K., Henslee-Downey, P., Mehta, J. et al. Long term disease-free survival in acute leukemia patients recovering with increased γδ T cells after partially mismatched related donor bone marrow transplantation. Bone Marrow Transplant 39, 751–757 (2007). https://doi.org/10.1038/sj.bmt.1705650

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