Donor leukocyte infusion after hematopoietic stem cell transplantation in patients with juvenile myelomonocytic leukemia

A. Yoshimi, P. Bader, S. Matthes-Martin, J. Starý, P. Sedlacek, U. Duffner, T. Klingebiel, D. Dilloo, W. Holter, F. Zintl, B. Kremens, K. W. Sykora, C. Urban, H. Hasle, E. Korthof, T. Révész, A. Fischer, P. Nöllke, F. Locatelli, C. M. Niemeyer

Research output: Contribution to journalArticle

Abstract

Juvenile myelomonocytic leukemia (JMML) is a clonal myeloproliferative disorder of early childhood. In all, 21 patients with JMML who received donor leukocyte infusion (DLI) after allogeneic hematopoietic stem cell transplantation (HSCT) for either mixed chimerism (MC, n=7) or relapse (n=14) were studied. Six patients had been transplanted from an HLA-matched sibling and 15 from other donors. Six of the 21 patients (MC: 3/7 patients; relapse: 3/14 patients) responded to DLI. Response rate was significantly higher in patients receiving a higher total T-cell dose (≥ × 107/kg) and in patients with an abnormal karyotype. None of the six patients receiving DLI from a matched sibling responded. Response was observed in five of six patients who did and in one of 15 children who did not develop acute graft-versus-host disease following DLI (P = 0.01). The overall outcome was poor even for the responders. Only one of the responders is alive in remission, two relapsed, and three died of complications. In conclusion, this study shows that some cases of JMML may be sensitive to DLI, this providing evidence for a graft-versus-leukemia effect in JMML. Infusion of a high number of T cells, strategies to reduce toxicity, and cytoreduction prior to DLI may improve the results.

Original languageEnglish
Pages (from-to)971-977
Number of pages7
JournalLeukemia
Volume19
Issue number6
DOIs
Publication statusPublished - Jun 2005

Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Donor leukocyte infusion
  • Graft-versus-host disease
  • Graft-versus-leukemia effect
  • Juvenile myelomonocytic leukemia
  • Mixed chimerism

ASJC Scopus subject areas

  • Hematology
  • Cancer Research

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    Yoshimi, A., Bader, P., Matthes-Martin, S., Starý, J., Sedlacek, P., Duffner, U., Klingebiel, T., Dilloo, D., Holter, W., Zintl, F., Kremens, B., Sykora, K. W., Urban, C., Hasle, H., Korthof, E., Révész, T., Fischer, A., Nöllke, P., Locatelli, F., & Niemeyer, C. M. (2005). Donor leukocyte infusion after hematopoietic stem cell transplantation in patients with juvenile myelomonocytic leukemia. Leukemia, 19(6), 971-977. https://doi.org/10.1038/sj.leu.2403721