1997
DOI: 10.1182/blood.v89.9.3113
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Donor Leukocyte Infusion for Leukemic Relapse After Allogeneic Marrow Transplantation: Lack of Residual Donor Hematopoiesis Predicts Aplasia

Abstract: We assessed the chimerism of CD34+ bone marrow cells before donor leukocyte infusion (DLI) on nine occasions in seven patients with leukemic relapse after allogeneic marrow transplantation. The patients suffered from acute lymphoblastic leukemia (n = 1), acute myeloid leukemia (n = 3), and chronic myeloid leukemia (CML; n = 3). Two patients received a second DLI because of disease progression after the first one. The origin of the CD34+ cells was determined by analyzing variable number of tandem repeats with p… Show more

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Cited by 109 publications
(28 citation statements)
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“…10 The cumulative incidence of DLI-induced cytopenia in our cohort was similar to that found after DLI for malignant diseases (18-50%) 9,10 : in those studies, a lower level of donor chimerism was recognized as a risk factor. 9,10 In the present study, acute GVHD after DLI was associated with development of cytopenia. make the important observation that DLI is a promising treatment for most patients having a higher level of donor chimerism, while second HSCT contributes to higher rates of stable engraftment and is beneficial for patients having lower levels of donor chimerism.…”
Section: Discussionsupporting
confidence: 52%
“…10 The cumulative incidence of DLI-induced cytopenia in our cohort was similar to that found after DLI for malignant diseases (18-50%) 9,10 : in those studies, a lower level of donor chimerism was recognized as a risk factor. 9,10 In the present study, acute GVHD after DLI was associated with development of cytopenia. make the important observation that DLI is a promising treatment for most patients having a higher level of donor chimerism, while second HSCT contributes to higher rates of stable engraftment and is beneficial for patients having lower levels of donor chimerism.…”
Section: Discussionsupporting
confidence: 52%
“…Antileukaemic effectors presumably proliferate in vivo after the infusion, and presumably must reach a threshold level to eradicate the leukaemia and normal haematopoietic cells that are host derived (Hoffmann et al , 1993). Marrow aplasia may occur unless sufficient donor‐derived normal progenitors are present to restore haematopoiesis (Keil et al , 1997). Consistent with this premise, CML patients with advanced relapse more frequently develop marrow aplasia than patients treated in cytogenetic or early haematological relapse (Van Rhee et al , 1994; Keil et al , 1997).…”
Section: Donor Lymphocyte Infusions (Dli)mentioning
confidence: 99%
“…Marrow aplasia may occur unless sufficient donor‐derived normal progenitors are present to restore haematopoiesis (Keil et al , 1997). Consistent with this premise, CML patients with advanced relapse more frequently develop marrow aplasia than patients treated in cytogenetic or early haematological relapse (Van Rhee et al , 1994; Keil et al , 1997). Patients developing aplasia generally recover after a second infusion of donor haematopoietic stem cells from either marrow or mobilized peripheral blood.…”
Section: Donor Lymphocyte Infusions (Dli)mentioning
confidence: 99%
“…In patients receiving the Seattle protocol, the numbers of days with ANC below 0.5 × 10 9 per L and PLT counts below 20 × 10 9 per L are given. For serially chimerism, analyses on Days 28, 56, 84, 180, and 360 after RIC‐HPBPCT CD3+ and CD33+ peripheral blood cells and granulocytes were isolated with flow cytometry 15 . Quantitative chimerism analysis was based on amplification of the STR loci D3S1358, vWA, FGA, TH01, TPOX, CSF1PO, D13S317, and D7S820 and the sex marker amelogenin with a PCR amplification kit as recommended by the manufacturer (AmpFlSTR Profiler, Applied Biosystems, Foster City, CA).…”
Section: Methodsmentioning
confidence: 99%