TY - JOUR
T1 - Transplantation of allogeneic CD34+-selected cells followed by early T-cell add-backs
T2 - Favorable results in acute and chronic myeloid leukemia
AU - Kobbe, Guido
AU - Fenk, R.
AU - Neumann, F.
AU - Bernhardt, A.
AU - Steidl, U.
AU - Kondakci, M.
AU - Graef, T.
AU - Aivado, M.
AU - Vaupel, M.
AU - Huenerlituerkoglu, A. N.
AU - Kronenwett, R.
AU - Pape, H.
AU - Hildebrand, B.
AU - Germing, U.
AU - Haas, R.
N1 - Funding Information:
This work was supported by the Leukämie Liga e.V.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2004
Y1 - 2004
N2 - 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.
AB - 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.
KW - CD34 selection
KW - Unrelated donor transplantation
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U2 - 10.1080/14653240410005375
DO - 10.1080/14653240410005375
M3 - Article
C2 - 15764020
AN - SCOPUS:19944418258
SN - 1465-3249
VL - 6
SP - 533
EP - 542
JO - Cytotherapy
JF - Cytotherapy
IS - 6
ER -