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Titolo:
DONOR LEUKOCYTE INFUSIONS IN 140 PATIENTS WITH RELAPSED MALIGNANCY AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION
Autore:
COLLINS RH; SHPILBERG O; DROBYSKI WR; PORTER DL; GIRALT S; CHAMPLIN R; GOODMAN SA; WOLFF SN; HU W; VERFAILLIE C; LIST A; DALTON W; OGNOSKIE N; CHETRIT A; ANTIN JH; NEMUNAITIS J;
Indirizzi:
BAYLOR UNIV,MED CTR,3535 WORTH ST,COLLINS BLDG,5TH FLOOR DALLAS TX 75246 TEXAS ONCOL PA DALLAS TX 00000 CHAIM SHEBA MED CTR IL-52621 TEL HASHOMER ISRAEL MED COLL WISCONSIN MILWAUKEE WI 53226 MD ANDERSON CANC CTR HOUSTON TX 77030 VANDERBILT UNIV NASHVILLE TN 00000 STANFORD UNIV PALO ALTO CA 94304 UNIV MINNESOTA MINNEAPOLIS MN 55455 UNIV ARIZONA TUCSON AZ 00000
Titolo Testata:
Journal of clinical oncology
fascicolo: 2, volume: 15, anno: 1997,
pagine: 433 - 444
SICI:
0732-183X(1997)15:2<433:DLII1P>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
GRAFT-VERSUS-LEUKEMIA; CHRONIC MYELOID-LEUKEMIA; CHRONIC MYELOGENOUS LEUKEMIA; PERIPHERAL-BLOOD LYMPHOCYTES; BUFFY COAT TRANSFUSIONS; T-CELL; HOST-DISEASE; ADOPTIVE IMMUNOTHERAPY; INTERFERON-ALPHA; BMT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
44
Recensione:
Indirizzi per estratti:
Citazione:
R.H. Collins et al., "DONOR LEUKOCYTE INFUSIONS IN 140 PATIENTS WITH RELAPSED MALIGNANCY AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION", Journal of clinical oncology, 15(2), 1997, pp. 433-444

Abstract

Purpose: Recipients of allogeneic bone marrow transplants (BMTs) who have relapsed may attain complete remissions when treated with transfusions of leukocytes obtained from the original bone marrow donor. We performed a retrospective study to characterize better this new treatment modality. Patients and Methods: We surveyed 25 North American BMT programs regarding their use of donor leukocyte infusions (DLI). Detailed forms were used to gather data regarding the original BMT, relapse,DLI, response to DLI, complications of DLI, and long-term follow-up evaluation. Reports of 140 patients were thus available for analysis. Results: Complete responses were observed in 60% (95% confidence interval [CI], 51.9% to 68.1%) of chronic myelogenous leukemia (CML) patients who received DLI and did not receive pre-DLI chemotherapy; response rates were higher in patients with cytogenetic and chronic-phase relapse (75.7%; 95% CI, 68.2% to 83.2%) than in patients with accelerated-phase (33.3%; 95% CI, 19.7% to 46.9%) or blastic-phase (16.7%; 95% CI, 1.9% to 31.9%) relapse. The actuarial probability of remaining in complete remission at 2 years was 89.6%. Complete remission rates in acutemyelogenous leukemia (AML) (n = 39) and acute lymphocytic leukemia (ALL) (n = 11) patients who had not received pre-DLI chemotherapy were 15.4% (95% CI, 9.6% to 21.2%) and 18.2% (95% CI, 6.6% to 29.8%), respectively. Complete remissions were also observed in two of four assessable myeloma patients and two of five assessable myelodysplasia patients, Complications of DLI included acute graft-versus-host disease (GVHD)(60%; 95% CI, 51.4% to 68.6%), chronic GVHD (60.7%; 95% CI, 50.3% to 71.1%), and pancytopenia (18.6%; 95% CI, 12.2% to 25.0%). Pre-DLI characteristics predictive of complete response in CML patients were post-BMT chronic GVHD, pre-DLI disease status of chronic phase, and time interval between BMT to DLI less than 2 years. Acute and chronic GVHD post-DLI were highly correlated with disease response (P < .00001). Conclusion: DLI results in complete remissions in a high percentage of patients with relapsed chronic-phase CML. Complete remissions are observed less frequently in patients with advanced CML and acute leukemia. GVHD and pancytopenia occur commonly; GVHD is highly correlated with response. (C) 1997 by American Society of Clinical Oncology.

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Documento generato il 28/09/20 alle ore 18:44:38