Graft-versus-Host Reactions and the Effectiveness of Donor ... - Core

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Weiden PL, Flournoy N, Thomas ED, et al. Antileukemic effect of graft-versus-host disease in human recipients of allo- geneic-marrow grafts. N Engl J Med. 1979 ...
Biology of Blood and Marrow Transplantation 12:414-421 (2006) 䊚 2006 American Society for Blood and Marrow Transplantation 1083-8791/06/1204-0004$32.00/0 doi:10.1016/j.bbmt.2005.11.520

Graft-versus-Host Reactions and the Effectiveness of Donor Lymphocyte Infusions Carol Ann Huff, Ephraim J. Fuchs, B. Douglas Smith, Amanda Blackford, Elizabeth Garrett-Mayer, Robert A. Brodsky, Ian W. Flinn, Richard F. Ambinder, Ivan M. Borrello, William H. Matsui, Georgia B. Vogelsang, Constance A. Griffin, Leo Luznik, Richard J. Jones Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University, Baltimore, Maryland Correspondence and reprint requests: Carol Ann Huff, MD, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, The Bunting-Blaustein Cancer Research Building, 1650 Orleans St., Room 209, Baltimore, MD 21231 (e-mail: [email protected]). Received June 24, 2005; accepted November 28, 2005

ABSTRACT We retrospectively analyzed 83 consecutive recipients of donor lymphocyte infusions (DLI) after allogeneic transplantation for factors associated with disease response and graft-versus-host disease (GVHD). DLI was highly effective in relapsed chronic phase chronic myeloid leukemia (CML), with 71% of patients achieving durable complete remissions (CR). In relapsed acute myeloid leukemia, DLI led to durable CRs in 31% of patients; the rate was 5 ⴛ 107 Time from BMT to DLI (d) 0-492 >492 Reason for DLI CML in CP Relapsed disease Donor chimerism before DLI 0%-50% 51%-100% Donor chimerism after DLI 0%-50% 51%-100%

Odds Ratio

P Value

95% CI

1.4 0.7 — 0.95

.58

2.7 1.4 —

.17

0.94-8.1 0.41-4.7 —

1.2 —

.70

0.48-3.0 —

3.0 —

.05

1.00-9.0 —

— 4.5

— 492 Donor chimerism before DLI 0%-50% 51%-100% Donor chimerism after DLI 0%-50% 51%-100% Reason for DLI CML in CP Relapsed disease Time from BMT to DLI

Hazard Ratio

P Value

95% CI

0.42 0.63 —

.22

0.14-1.3 0.29-1.4 —

0.56 0.50 0.58 —

.50

0.23-1.4 0.18-1.4 0.18-1.9 —

0.42 1.0 —

.11

0.17-1.1 0.44-2.3 —

0.65 —

.25

0.32-1.4

— 3.4