Transplantation of allogeneic CD34+-selected cells followed by early T-cell add-backs: Favorable results in acute and chronic myeloid leukemia

Guido Kobbe, R. Fenk, F. Neumann, A. Bernhardt, U. Steidl, M. Kondakci, T. Graef, M. Aivado, M. Vaupel, A. N. Huenerlituerkoglu, R. Kronenwett, H. Pape, B. Hildebrand, U. Germing, R. Haas

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11 Scopus citations

Abstract

Background. The aim of this study was to investigate preservation of anti-leukemic activity and protection from apportunistic infections after transplantation of allogeneic CD34+ cells in patients with hematologic malignancies and had prognosis. Methods. Thirty-three patients [median age 42 years range 23-55 years diagnosis AML/myelodysplastic syndrome (MDS) 14, ALL nine, CML seven and multiple myeloma (MM) three] received myeloablative conditioning followed by infusion of selected CD34+ cells from matched unrelated donors (31) or HLA-identical siblings (two). Early donor lymphocyte infusions (DLI; 0.5 and 1.0 × 106 CD3+ cells /kg) were given while patients were on immunosuppressive therapy. Results. Ninety-seven per cent of patients engrafted and 24 of 29 patients surviving more than 30 days received at least one pre-emptive DLI. Three patients (10%) developed acute (a)GvHD (two grade I-II, one grade III-IV) spontaneously, and 16 atients (67%) developed aGvHD after DLI (12 grade I-II, four grade III-IV). Eight of 24 evaluable patients developed chronic (c)GvHD (33%, six limited two extensive). After a median follow-up of 590 days (range 138-1610 days) 18 patients were alive (55%), 16 in complete remission (CR), one in hematologic and one in molecular relapse. Seven patients died after relapse (21%) and eight died from transplantation-related causes (24%). Patients with myeloid malignancies bad a significantly better survival than patients with ALL or MM (74%±10 vs. 30%±13, P < 0.05). Discussion. Early pre-emptive low-dose DLI following transplantation of selected CD34+ cells from unrelated donors after myeloablative conditioning is feasible and ejective without undue toxicity, especially in patients with myeloid malignancies.

Original languageEnglish (US)
Pages (from-to)533-542
Number of pages10
JournalCytotherapy
Volume6
Issue number6
DOIs
Publication statusPublished - Jan 1 2004
Externally publishedYes

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Keywords

  • CD34 selection
  • Unrelated donor transplantation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Oncology
  • Genetics(clinical)
  • Cell Biology
  • Cancer Research
  • Transplantation

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