TY - JOUR
T1 - Prophylactic T cell infusion after T cell-depleted bone marrow transplantation in patients with refractory lymphoma
AU - Lee, C. K.
AU - De Magalhaes-Silverman, M.
AU - Hohl, R. J.
AU - Hayashi, M.
AU - Buatti, J.
AU - Wen, B. C.
AU - Schlueter, A.
AU - Strauss, R. G.
AU - Gingrich, R. D.
PY - 2002
Y1 - 2002
N2 - Fifty-two patients with refractory lymphoma were prospectively treated with prophylactic T lymphocyte infusion after T cell-depleted allogeneic bone marrow transplantation, to induce graft-versus-lymphoma effect. Thirty-three patients had related donors; 19 had unrelated donors. After transplantation with marrow that had 0.8 ± 0.4 × 105 CD3+ cells/kg, T cells up to 1.75 × 106 CD3+ cells/kg were given over 3 months provided ≥ grade II acute graft-versus-host disease (GVHD) was not seen. The cumulative incidence of grades II-IV acute GVHD was 69%. Twenty of 32 evaluable patients (63%) developed chronic GVHD. Ten patients (19%) died of GVHD. The Kaplan-Meier 5-year overall survival of all patients was 34%. On multivariate analyses, chronic GVHD was significant for relapse (hazard ratio of 1.7, P < 0.05), and for overall survival (hazard ratio 1.4, P< 0.001). Chemosensitivity was significant for relapse only on univariate analysis. Patients who developed chronic GVHD had 4 years median survival, compared with 9 months in patients without chronic GVHD, P < 0.001. The study shows that patients with chronic GVHD have superior survivals, most probably related to a graft-versus-lymphoma effect, which could be modulated by prophylactic T cell infusion.
AB - Fifty-two patients with refractory lymphoma were prospectively treated with prophylactic T lymphocyte infusion after T cell-depleted allogeneic bone marrow transplantation, to induce graft-versus-lymphoma effect. Thirty-three patients had related donors; 19 had unrelated donors. After transplantation with marrow that had 0.8 ± 0.4 × 105 CD3+ cells/kg, T cells up to 1.75 × 106 CD3+ cells/kg were given over 3 months provided ≥ grade II acute graft-versus-host disease (GVHD) was not seen. The cumulative incidence of grades II-IV acute GVHD was 69%. Twenty of 32 evaluable patients (63%) developed chronic GVHD. Ten patients (19%) died of GVHD. The Kaplan-Meier 5-year overall survival of all patients was 34%. On multivariate analyses, chronic GVHD was significant for relapse (hazard ratio of 1.7, P < 0.05), and for overall survival (hazard ratio 1.4, P< 0.001). Chemosensitivity was significant for relapse only on univariate analysis. Patients who developed chronic GVHD had 4 years median survival, compared with 9 months in patients without chronic GVHD, P < 0.001. The study shows that patients with chronic GVHD have superior survivals, most probably related to a graft-versus-lymphoma effect, which could be modulated by prophylactic T cell infusion.
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U2 - 10.1038/sj.bmt.1703426
DO - 10.1038/sj.bmt.1703426
M3 - Article
C2 - 11979313
AN - SCOPUS:85047700329
SN - 0268-3369
VL - 29
SP - 615
EP - 620
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 7
ER -