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Chronic Myeloproliferative Disorders

Response to donor lymphocyte infusions for chronic myeloid leukemia is dose-dependent: the importance of escalating the cell dose to maximize therapeutic efficacy

Leukemia volume 21, pages 943–948 (2007)Cite this article

Abstract

Donor lymphocyte infusions (DLI) are an effective treatment for patients with chronic myeloid leukemia (CML) in relapse after allografting but the optimal cell dose has yet to be identified. To address this question, we investigated the factors affecting the dose required to achieve remission (effective cell dose, (ECD)) in 81 patients treated with an escalating dose regimen. The overall proportion of patients who achieved a molecular remission was 88%. The cumulative proportion of remitters increased significantly at each dose level. With a CD3+ cell dose ⩽107/kg, 56% of patients in molecular/cytogenetic relapse obtained molecular remission, whereas only 20% of those in hematologic relapse did so. At the same cell dose, 58% of patients who received lymphocytes from volunteer unrelated donors achieved remission, as compared to 29% of those who received DLI from sibling donors. We conclude that the response to DLI is dose-dependent and that the ECD is influenced by the quantity and phase of CML at relapse and degree of donor/recipient histocompatibility.

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Acknowledgements

This work was partly supported by the Leukemia Research Fund. C Fozza is the recipient of the fellowship ‘Master and back TS 07’ offered by Regione Autonoma della Sardegna.

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  1. M P Simula and S Marktel: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, Imperial College at Hammersmith Hospital, London, UK

    M P Simula, S Marktel, C Fozza, J Kaeda, R M Szydlo, E Nadal, M Bua, A Rahemtulla, E Kanfer, D Marin, E Olavarria, J M Goldman, J F Apperley & F Dazzi

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  1. M P Simula
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Correspondence to F Dazzi.

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Simula, M., Marktel, S., Fozza, C. et al. Response to donor lymphocyte infusions for chronic myeloid leukemia is dose-dependent: the importance of escalating the cell dose to maximize therapeutic efficacy. Leukemia 21, 943–948 (2007). https://doi.org/10.1038/sj.leu.2404641

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