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Graft-Versus-Tumor Effects

Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population

Bone Marrow Transplantation volume 42, pages 201–205 (2008)Cite this article

Abstract

Donor leukocyte infusions (DLI) can reverse relapse of hematologic malignancy following allogeneic hematopoietic stem cell transplant (HSCT) in some cases. Little is known regarding the effectiveness of DLI in children who relapse after HSCT. We report outcomes of 49 children who received DLI for relapse after allogeneic transplant. Prognosis was particularly poor (0/14 responses) for patients relapsing within 6 months from transplant. DLI rarely induced remission when given as sole therapy for marrow relapse. One-year disease-free survival was 30% (6/20) in patients who received DLI as consolidation following chemotherapy. The development of GVHD grades 1–2 was associated with superior 3-year survival than patients who developed GVHD grades 3–4 (P<0.002). To determine the benefit of DLI, 45 children who received DLI for relapse (four children without matches were excluded) were compared to 1229 children with similar characteristics whose relapse was not treated with DLI. There was no difference in survival (P=0.30) once adjustments were made to account for the time from relapse to DLI. Although a few children achieved durable remissions when DLI was used as part of a post-relapse treatment strategy, DLI was unsuccessful in the majority of cases. Strategies may be better directed at preempting post transplant relapse.

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Authors and Affiliations

  1. Departments of Pediatrics and Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    J E Levine

  2. National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA

    A J Barrett

  3. Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA

    M-J Zhang, M Arora, F Loberiza, D Wang & M M Horowitz

  4. Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA

    M A Pulsipher

  5. Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA

    N Bunin

  6. Department of Hematology/Oncology, Miami Children's Hospital, Miami, FL, USA

    J Fort

  7. Bone Marrow and Stem Cell Transplant Program, University of Pennsylvania, Philadelphia, PA, USA

    D Porter

  8. Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, TX, USA

    S Giralt

  9. Bone Marrow Transplant Program, Medical College of Wisconsin, Milwaukee, WI, USA

    W Drobyski

  10. National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    S Pavletic

  11. Centre for Allogeneic Stem Cell Transplantation, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden

    O Ringden

  12. Department of Internal Medicine, Hematopoietic Cell Transplantation Program, University of Texas Southwestern Medical Center, Dallas, TX, USA

    R Collins Jr

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  1. J E Levine
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  2. A J Barrett
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  3. M-J Zhang
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  4. M Arora
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  5. M A Pulsipher
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  6. N Bunin
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  7. J Fort
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  8. F Loberiza
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  9. D Porter
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  10. S Giralt
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  11. W Drobyski
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  12. D Wang
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  13. S Pavletic
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  14. O Ringden
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  15. M M Horowitz
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  16. R Collins Jr
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Correspondence to J E Levine.

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Levine, J., Barrett, A., Zhang, MJ. et al. Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population. Bone Marrow Transplant 42, 201–205 (2008). https://doi.org/10.1038/bmt.2008.135

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  • DOI: https://doi.org/10.1038/bmt.2008.135

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