GRAFT-VERSUS-LEUKEMIA EFFECT OF DONOR LYMPHOCYTE TRANSFUSIONS IN MARROW GRAFTED PATIENTS
GRAFT-VERSUS-LEUKEMIA EFFECT OF DONOR LYMPHOCYTE TRANSFUSIONS IN MARROW GRAFTED PATIENTS
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DOI：
10.1182/blood.v86.5.2041.bloodjournal8652041
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发表时间：
1995-09-01
期刊：
影响因子：
20.3
通讯作者：
ANSARI, H
中科院分区：
文献类型：
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作者：
KOLB, HJ;SCHATTENBERG, A;ANSARI, H
同种异性淋巴细胞的免疫反应性在控制骨髓移植后的白血病中起主要作用。在骨髓移植后复发性白血病的患者中，嵌合和耐受性为用供体淋巴细胞提供了免疫疗法的理想条件。我们研究了供体淋巴细胞输血对骨髓移植后复发中急性和慢性白血病的影响。一百三十五例慢性粒细胞性白血病（CML）（n = 84），急性髓样白血病（AML）（n = 23），急性淋巴细胞白血病（ALL）（n = 22），骨髓增生性综合征（MDS）（N = 22）（N = 22）（N = 22）（N = 22） = 5）和骨髓纤维化（PCV）（n = 1）的多余一环菌Vera被处理供体淋巴细胞的输血。监测患者的白血病反应，包括在CML中，将聚合酶链反应用于BCR/ABL mRNA转录本，以及发生移植物抗宿主病（GVHD）和骨髓抑制的发生。 54例CML患者（73％）的供体淋巴细胞输血诱导了完全缓解，并且PCV完全缓解的患者也被诱导了5例AML和一名MDS患者的患者（29％）。相比之下，所有人都没有对供体淋巴细胞输血的收养免疫疗法做出反应。在慢性期接受CML治疗的患者（缓解概率：3年时87％）的患者中恢复持久。还将淋巴细胞输血给18例所有，AML，MDS和转化的CML患者，这些患者在化学疗法后正在缓解。这些减免不耐用。 52例患者（41％）患有2级或更高级的GVHD，41例患者（34％）显示出骨髓抑制的迹象。 17例患者没有白血病，14例GVHD患者和/或骨髓抑制。供体淋巴细胞输血对髓样形式的白血病发挥强大作用，并在CML中诱导持久的恢复。 （c）1995年美国血液学学会。
The immune reactivity of allogeneic lymphocytes plays a major role in the control of leukemia after bone marrow transplantation. In patients with recurrent leukemia after marrow transplantation, chimerism and tolerance provide ideal conditions for adoptive immunotherapy with donor lymphocytes. We studied the effect of donor lymphocyte transfusions on acute and chronic leukemia in relapse after bone marrow transplantation. One hundred thirty-five patients with chronic myeloid leukemia (CML) (N = 84), acute myeloid leukemia (AML) (N = 23), acute lymphoblastic leukemia (ALL) (N = 22), myelodysplastic syndrome (MDS) (N = 5), and polycythemia vera with osteomyelofibrosis (PCV) (N = 1) were treated with transfusions of donor lymphocytes. Patients were monitored for response of leukemia, including in CML, the use of the polymerase chain reaction for bcr/abl mRNA transcripts and for the occurrence of graft-versus-host disease (GVHD) and myelosuppression. Complete remissions were induced by donor lymphocyte transfusions in 54 patients with CML (73%) and in the patient with PCV complete remissions were also induced in five patients (29%) with AML and a patient with MDS. In contrast, ALL did not respond to adoptive immunotherapy with donor lymphocyte transfusions. Remissions were durable in patients treated for CML in chronic phase (probability of remission: 87% at 3 years). Lymphocyte transfusions were also given to 18 patients with ALL, AML, MDS, and transformed phase CML who were in remission after chemotherapy. These remissions were not durable. Fifty-two patients (41%) developed GVHD of grade 2 or more, and 41 patients (34%) showed signs of myelosuppression. Seventeen patients died without leukemia, 14 patients with GVHD and/or myelosuppression. Donor lymphocyte transfusions exert strong effects against myeloid forms of leukemia and induce durable remissions in CML. (C) 1995 by The American Society of Hematology.