Fludarabine/cyclophosphamide was well tolerated and allowed consistent engraftment in lymphoma allografted patients. Response rates were high in this group of refractory and heavily pretreated patients. This dual procedure seems to be most promising in patients with end-stage malignant lymphomas.

We have developed a new system for the production of autologous platelet-rich plasma and red blood cell concentrates to be used in autologous transfusion support of cardiac surgery patients. In 15 operations no homologous blood products were required. Costs were diminished since with the same harness it was possible to carry out the intraoperative blood salvage and concentrate the erythrocytes contained in the oxygenator and its lines. Indirect costs were also reduced since no infective complication was observed due to homologous blood products.

Intensive chemotherapy given in early chronic phase of CML is well tolerated and results in high numbers of circulating Ph1-negative precursor cells.

No abstract

Summary:and discontinuation of infusions before life-threatening GVHD has developed. Donor lymphocyte infusions (DLI) were given between Keywords: chronic myeloid leukemia; graft-versusJune 1990 and March 1996 to 18 patients with chronic leukemia; donor lymphocyte infusions myeloid leukemia (CML) for the treatment of cytogenetic (n ‫؍‬ 6) or hematologic relapse (n ‫؍‬ 12) following an allogeneic bone marrow transplant (BMT). Patients were divided in two groups: patients in group A (n ‫؍‬ 8)Graft-versus-leukemia (GVL) is thought to play an received a large dose of donor lymphocytes important role in preventing relapse in patients undergoing (у1 ؋ 10 8 /kg), whereas patients in group B (n ‫؍‬ 10) allogeneic bone marrow transplants (BMT). 1,2 Although received escalating numbers of cells (2 ؋ 10 5 up to GVL was described in animals almost 20 years ago 3,4 little 2 ؋ 10 8 /kg). The median number of DLI in group A was is known about the magnitude of this effect on effector cells 2 (range 1-3); the median number of infusions in group and target antigens, at least in humans. 5 In the experimental B was 7 (range 3-9). Acute GVHD occurred in 12 animal, cells separately mediating GVL or graft-versus-host patients (grades I-III) and was a major cause of death disease (GVHD) have been described and can be identified in two. The risk of developing GVHD correlated with by surface markers. 3,6 In humans we have indirect evidence the number of cells infused: 37%, 14%, 5% and 0%for GVL: programs involving T cell depletion expose the for DLI with cells у1 ؋ 10 8 , 2 ؋ 10 7 /kg, 2 ؋ 10 6 /kg, and patients to a high risk of leukemic relapse, 2 and this has 2 ؋ 10 5 /kg, respectively (P ‫؍‬ 0.01). Median transaminnow been shown in very large numbers of patients.1,2 ase levels were found to be significantly increased in If mature donor T cells infused on the day of marrow patients with, as compared to patients without, acute transplant (an average of 6 × 10 7 /kg) have such an GVHD (GPT 412 vs 28 IU/l; P ‫؍‬ 0.03). Severe aplasia important role in preventing relapse, the use of large numoccurred in four and was a contributing cause of death bers of donor T cells which have undergone maturation in in two patients. Overall, four patients died as a consethe donor thymus, would possibly be helpful in treating quence of DLI and all received Ͼ1 ؋ 10 8 /kg cells: the relapse. Indeed this has been shown to be the case, actuarial risk was 38% in group A and 14% in group especially in patients with chronic myeloid leukemia B (P ‫؍‬ 0.1). There were 10 complete and three partial (CML), both for unfractionated 7-17 and CD8-depleted cytogenetic responses: the actuarial probability at 5 cells.18 years of being Ph negative was 69%: it was 46% for The exact mechanism by which the leukemic clone can group A and 85% for group B (P ‫؍‬ 0.1). The longest be reduced is unknown. GVHD has a deleterious effect on patient is now 6 years post-DLI, Ph negative, BCR-ABL hematopoietic cells 19,20 and it is quite possible that the sonegative. The actuarial 3 y...