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Graft-Versus-Tumor Effects

Donor lymphocyte infusions for the treatment of chronic myeloid leukemia relapse following peripheral blood or bone marrow stem cell transplantation

Bone Marrow Transplantation volume 48, pages 837–842 (2013)Cite this article

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Abstract

Peripheral blood used as a source of stem cells for transplantation (PBSCT) is known to exert stronger immune-mediated effects compared with BM (BMT). We decided to retrospectively analyze the impact of stem cell source on the OS of CML patients who relapsed after either matched related donor PBSCT (N=168) or BMT (N=216) and were treated with donor lymphocyte infusions (DLI). Univariate analysis revealed a lower probability of OS after DLI in patients relapsing after PBSCT vs BMT (66% vs 79% at 5 years, P=0.013). However, a multivariate Cox analysis did not reveal any significant impact of PBSCT as a risk factor for decreased OS for patients transplanted in first chronic phase (CP1; hazard ratio (HR) 1.036, 95% confidence interval (CI) 0.619–1.734). A statistical interaction term suggested that the impact of stem cell source on OS after DLI was different for those transplanted in advanced phases (negative impact of previous PBSCT—HR 2.176, 95% CI 0.930–5.091). In summary, the stem cell source does not affect the OS of CML patients who underwent PBSCT in CP1, relapsed and were treated with DLI. However, when the patients were transplanted in advanced phases, previous PBSCT seems to negatively affect OS after DLI compared with BMT.

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Authors and Affiliations

  1. Department of Hematology, Oncology and Internal Diseases, The Medical University of Warsaw, Warsaw, Poland

    G W Basak, W Wiktor-Jedrzejczak & K Halaburda

  2. Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, Netherlands

    L C de Wreede & A van Biezen

  3. Klinikum Augsburg, II Medizinische Klinik, University of Munich, Augsburg, Germany

    C Schmid

  4. Department of Hematology, Radboud University—Nijmegen Medical Centre, Nijmegen, Netherlands

    N Schaap

  5. Department of Medicine, Imperial College, London, UK

    F Dazzi

  6. Leiden University Medical Centre, Leiden, Netherlands

    P A von dem Borne

  7. Department of Hematology, University Medical Centre, Utrecht, Netherlands

    E Petersen

  8. Department of Bone Marrow Transplantation, University Hospital, Essen, Germany

    D Beelen

  9. Cape Hematology and Bone Marrow Transplant Unit, Constantiaberg Medi-Clinic, Cape Town, South Africa

    A Abayomi

  10. Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland

    L Volin

  11. Service Hematologie Adulte, Hôpital Necker, Paris, France

    A Buzyn

  12. Department of Hematology, Ankara University Faculty of Medicine, Ankara, Turkey

    G Gurman

  13. Klinik für Innere Medzin III, Universitätsklinikum Ulm, Ulm, Germany

    D Bunjes

  14. II Facoltà di Medicina e Chirurgia, Università La Sapienza, Rome, Italy

    C Guglielmi

  15. Servicio de Hematologia, Hospital de Navarra, Pamplona, Spain

    E Olavarria

  16. Department of Hematology, University Medical Centre St. Radboud, Nijmegen, Netherlands

    T de Witte

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  1. G W Basak
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  2. L C de Wreede
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  6. C Schmid
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  10. E Petersen
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  11. D Beelen
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  15. G Gurman
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  16. D Bunjes
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  17. C Guglielmi
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  18. E Olavarria
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  19. T de Witte
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Chronic Malignancies Working Party EBMT.

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Correspondence to G W Basak.

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Basak, G., de Wreede, L., van Biezen, A. et al. Donor lymphocyte infusions for the treatment of chronic myeloid leukemia relapse following peripheral blood or bone marrow stem cell transplantation. Bone Marrow Transplant 48, 837–842 (2013). https://doi.org/10.1038/bmt.2012.234

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