Long-term follow-up of patients who achieved complete remission after donor leukocyte infusions. Biol Blood Marrow Transplant 1999;5(4):253-61
Date
08/28/1999Pubmed ID
10465105DOI
10.1053/bbmt.1999.v5.pm10465105Scopus ID
2-s2.0-0032605618 (requires institutional sign-in at Scopus site) 99 CitationsAbstract
Donor leukocyte infusions (DLI) can induce a direct graft-vs-leukemia (GVL) reaction and restore complete remission for patients who relapse after allogeneic bone marrow transplantation (BMT). A critical and unanswered concern is the long-term safety and durability of DLI. To determine remission duration, long-term toxicity, and survival after DLI-induced remissions, we identified 73 patients who achieved complete remission after DLI. Follow-up information was obtained for 66 of the 73 patients, including 39 patients with chronic myelogenous leukemia (CML) and 27 patients with other diseases. Median follow-up for all patients was 32 months; the probability of survival at 1, 2, and 3 years was 83% (95% confidence interval [CI] 74-92), 71% (60-83), and 61% (49-74), respectively. For CML, survival probability at 1, 2, and 3 years was 87% (76-98), 76% (62-90), and 73% (58-88). For other diseases, survival probability at 1 and 2 years is 77% (61-93) and 65% (46-84). Five of 39 patients with CML relapsed, and 11 of 27 patients with other diseases relapsed. Treatment-related toxicity accounted for 10 deaths. Extended follow-up shows that DLI-induced remissions are durable, especially for patients with CML. Late relapses still occur, however, and toxicity remains significant. Continued follow-up will best define the long-term GVL effects of DLI, especially for diseases other than CML.
Author List
Porter DL, Collins RH Jr, Shpilberg O, Drobyski WR, Connors JM, Sproles A, Antin JHAuthor
William R. Drobyski MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Bone Marrow Transplantation
Child
Disease-Free Survival
Female
Follow-Up Studies
Graft vs Host Disease
Graft vs Tumor Effect
Humans
Leukemia
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Leukocyte Transfusion
Male
Middle Aged
Multivariate Analysis
Safety
Survival Rate
Time Factors
Transplantation, Homologous
