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Response to donor lymphocyte infusions for chronic myeloid leukemia is dose-dependent: the importance of escalating the cell dose to maximize therapeutic efficacy

Simula, Maria Paola and Marktel, Sarah and Fozza, Claudio and Kaeda, Jaspal and Szydlo, Richard M. and Nadal, Elisabet and Bua, Marco and Rahemtulla, Amin and Kanfer, Edward J. and Marin, David and Olavarria, Eduardo and Goldman, John M. and Apperley, Jane F. and Dazzi, Francesco (2007) Response to donor lymphocyte infusions for chronic myeloid leukemia is dose-dependent: the importance of escalating the cell dose to maximize therapeutic efficacy. Leukemia, Vol. 21 (5), p. 943-948. eISSN 1476-5551. Article.

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DOI: 10.1038/sj.leu.2404641

Abstract

Donor lymphocyte infusions (DLI) are an effective treatment for patients with chronic myeloid leukemia (CML) in relapse after allografting but the optimal cell dose has yet to be identified. To address this question, we investigated the factors affecting the dose required to achieve remission (effective cell dose, (ECD)) in 81 patients treated with an escalating dose regimen. The overall proportion of patients who achieved a molecular remission was 88%. The cumulative proportion of remitters increased significantly at each dose level. With a CD3+ cell dose ≥ 107/kg, 56% of patients in molecular/cytogenetic relapse obtained molecular remission, whereas only 20% of those in hematologic relapse did so. At the same cell dose, 58% of patients who received lymphocytes from volunteer unrelated donors achieved remission, as compared to 29% of those who received DLI from sibling donors. We conclude that the response to DLI is dose-dependent and that the ECD is influenced by the quantity and phase of CML at relapse and degree of donor/recipient histocompatibility.

Item Type:Article
ID Code:4408
Status:Published
Refereed:Yes
Uncontrolled Keywords:Donor lymphocyte infusions, chronic myeloid leukemia, effective cell dose, escalating dose regimen, allogeneic stem cell transplantation
Subjects:Area 06 - Scienze mediche > MED/15 Malattie del sangue
Divisions:001 Università di Sassari > 03 Istituti > Ematologia
Publisher:Nature Publishing Group
eISSN:1476-5551
Deposited On:31 Aug 2010 17:36

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