Persistent Multiyear Control of Relapsed T‐Cell Acute Lymphoblastic Leukemia With Successive Donor Lymphocyte Infusions: A Case Report

Huo, Jeffrey S.; Symons, Heather J.; Robey, Nancy; Borowitz, Michael J.; Schafer, Eric S.; Chen, Allen

doi:10.1002/pbc.25971

Cited by 5 publications

(2 citation statements)

References 18 publications

(32 reference statements)

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“…These results indicate that using DLI to eradicate residual leukemic clones in T-ALL patient after HSCT is quiet useful and helpful for prolonging the survival of patients and preventing leukemia recurrence. Allen et al reported similar results in a study in which DLI successfully controlled MRD and led to a disease-free survival of more than 3 years for a 9-year-old T-ALL patient [11]. These results indicate that DLI may be used as a common strategy for T-ALL patients with MRD after HSCT.…”

Section: Discussionmentioning

confidence: 63%

Persistent donor derived Vδ4 T cell clones may improve survival for recurrent T cell acute lymphoblastic leukemia after HSCT and DLI

Weng

Huang

et al. 2016

Oncotarget

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The outcome for T-cell acute lymphoblastic leukemia (T-ALL) in relapse after hematopoietic stem cell transplantation (HSCT) is quite poor, while, both donor lymphocytes infusion (DLI) and adoptively infusion of γδ T cells in leukemia patients after HSCT have demonstrated good results in prolonging survival time of patients. Here, we reported a T-ALL case who experienced three relapses and received HSCT and DLI with an overall survival (OS) time lasting for more than seven years. Based on our previous identification of a leukemic and reactive clone in this patient, continual γδ T cell repertoire monitoring affirmed that the same Vδ5 leukemic clone existed in most samples from the patient, particularly including a sample taken at the time of the third T-ALL relapse, while it could not be detected in the donor sample. In addition, an identical Vδ4 monoclonal T cell that proliferated in the recipient for several years was confirmed to come from the donor graft, and its expression level significantly increased in third leukemia recurrence. These results indicate that clonally expanded Vδ4 T cells may represent a reconstituted γδ T cell repertoire after HSCT, which also hints to a relatively better outcome for this case. Based on this case study, we recommend DLI should be as a treatment strategy for patients who achieve CR or relapse from HSCT. Moreover, dynamically monitoring the TCR repertoire in patients who receive HSCT will benefit in supervising of malignant clone evolution and residue, identifying T cell clones mediate anti-infection, GvHD or GvL.

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Section: Discussionmentioning

confidence: 63%

Persistent donor derived Vδ4 T cell clones may improve survival for recurrent T cell acute lymphoblastic leukemia after HSCT and DLI

Weng

Huang

et al. 2016

Oncotarget

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“…From this limited published literature, it appears that in contrast to AML, in which non-targeted adoptive cell therapies with DLI or NK cells can produce significant benefit, similar approaches in T-ALL had only modest effects. While in rare instances patients with refractory or relapsed T-ALL responded to DLI (alone or in combination with chemotherapy) 33,34 , in most patients the efficacy of such non-specific cell therapy approaches was limited, highlighting the need for more effective targeted cell therapy options.…”

Section: C1 Dlis Tcr-and Nk-based Therapies For T-allmentioning

confidence: 99%

Adoptive Cell Therapy for Acute Myeloid Leukemia and T-Cell Acute Lymphoblastic Leukemia

2019

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Refractory and relapsed acute myeloid leukemia (AML) and T-lineage leukemia (T-ALL) have poor prognosis and limited therapeutic options. Adoptive cellular immunotherapies are emerging as an effective treatment for patients with chemotherapy refractory hematological malignancies. Indeed the use of unselected donor lymphocyte infusions (DLIs) have demonstrated successes in treating patients with AML and TALL post-allogeneic The development of ex vivo manipulation techniques such as genetic modification or selection and expansion of individual cellular components has permitted the clinical translation of a wide range of promising cellular therapies for AML and TALL. Here, we will review clinical studies to date using adoptive cell therapy approaches and outline the major challenges limiting the development of safe and effective cell therapies for both types of acute leukemia.

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Considerations for Cancer-Directed Therapy in Advanced Childhood Cancer

Feraco

Manfredini

Jankovic

et al. 2017

Palliative Care in Pediatric Oncology

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Persistent Multiyear Control of Relapsed T‐Cell Acute Lymphoblastic Leukemia With Successive Donor Lymphocyte Infusions: A Case Report

Cited by 5 publications

References 18 publications

Persistent donor derived Vδ4 T cell clones may improve survival for recurrent T cell acute lymphoblastic leukemia after HSCT and DLI

Persistent donor derived Vδ4 T cell clones may improve survival for recurrent T cell acute lymphoblastic leukemia after HSCT and DLI

Adoptive Cell Therapy for Acute Myeloid Leukemia and T-Cell Acute Lymphoblastic Leukemia

Considerations for Cancer-Directed Therapy in Advanced Childhood Cancer

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