Management of chronic myeloid leukaemia in relapse following donor lymphocyte infusion induced remission: A retrospective study of the clinical trials committee of the British Society of Blood & Marrow Transplantation (BSBMT)

M. Cummins, K. Cwynarski, S. Marktel, F. Dazzi, J. Cavenagh, R. E. Clark, T. L. Holyoake, D. Milligan, A. Parker, N. H. Russell, David I. Marks

Research output: Contribution to journalArticlepeer-review

Abstract

Donor lymphocyte infusion (DLI) can restore remission in a high percentage of patients with chronic myeloid leukaemia (CML) who relapse after allogeneic stem cell transplant (SCT). Subsequent relapses after a DLI-induced remission do occur and the optimal management of these patients is not defined. A retrospective study of the practice of UK transplant centres was conducted. In all, 13 patients from seven centres were identified: all were treated for relapse post allogeneic SCT with DLI and achieved either a complete cytogenetic (n=5) or molecular (n=8) remission. All patients subsequently had a second relapse, at molecular (n=7), cytogenetic (n=4) and haematological (n=2) levels. Further DLI was used in the treatment of 11 patients, imatinib mesylate in three and chemotherapy in two. The two patients with haematological relapse died of blastic disease. The remaining 11 patients achieved either a complete cytogenetic (n=2) or molecular (n=9) remission. Nine patients remain in molecular remission at a median follow-up of 29 months, seven of whom had received DLI alone as treatment for second relapse, one DLI plus imatinib and one imatinib alone. Toxicity following DLI for second relapse was low. Longer follow-up will be required to see if these second DLI-induced remissions will be durable.

Original languageEnglish
Pages (from-to)1065-1069
Number of pages5
JournalBone Marrow Transplantation
Volume36
Issue number12
DOIs
Publication statusPublished - Dec 2005

Keywords

  • Chronic myeloid leukaemia
  • Donor lymphocyte infusion
  • Imatinib mesylate
  • Relapse
  • Stem cell transplantation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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