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Graft-versus-Tumor Effects

Prognostic factors for donor lymphocyte infusions following non-myeloablative allogeneic stem cell transplantation in multiple myeloma

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Abstract

In this retrospective study, we evaluated donor lymphocyte infusions given for relapsed (n=48) or persistent (n=15) myeloma following non-myeloablative allogeneic stem cell transplantation (Allo-SCT). Twenty-four of 63 patients (38.1%) responded: 12 patients (19.0%) with a partial response (PR) and 12 patients (19.0%) with a complete response (CR). Overall survival after donor lymphocyte infusions (DLI) was 23.6 months (1.0–50.7+). Median overall survival for non-responding patients was 23.6 months and has not been reached for the patients responding to DLI. In responders, progression-free survival after DLI was 27.8 months (1.2–46.2+). Patients with a PR had a median progression-free survival of 7.0 months, whereas patients with a CR to DLI had a median progression-free survival of 27.8 months. Major toxicities were acute graft-versus-host disease (GVHD) (38.1%) and chronic GVHD (42.9%). Seven patients (11.1%) died from treatment-related mortality. The only significant prognostic factors for response to DLI were the occurrence of acute and chronic GVHD. There was a trend towards significance for time between transplantation and DLI, and response. Donor lymphocyte infusion following non-myeloablative Allo-SCT is a valuable strategy for relapsed or persistent disease.

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Authors and Affiliations

  1. Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands

    N W C J van de Donk, L F Verdonck & H M Lokhorst

  2. Unit of Bone Marrow Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    N Kröger & F A Ayuk

  3. Department of Hematology/Oncology, Clinic of Internal Medicine, University of Heidelberg, Heidelberg, Germany

    U Hegenbart & H Goldschmidt

  4. Department of Hematology and Bone Marrow Transplantation, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy

    P Corradini & V Montefusco

  5. Servicio de Hematologia, Hospital Clinico Universitario de Salamanca, Salamanca, Spain

    J F San Miguel & J A Perez-Simon

  6. Department of Hematology, Erasmus MC, Rotterdam, The Netherlands

    M Zijlmans

  7. Department of Hematology, University Medical Center Nijmegen, St Radboud University, Nijmegen, The Netherlands

    R A Raymakers

  8. Department of Hematology, Academic Medical Center, Amsterdam, The Netherlands

    M H J van Oers

  9. Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel

    A Nagler

Authors
  1. N W C J van de Donk
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  2. N Kröger
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  3. U Hegenbart
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  4. P Corradini
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  5. J F San Miguel
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  6. H Goldschmidt
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  7. J A Perez-Simon
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  8. M Zijlmans
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  9. R A Raymakers
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  10. V Montefusco
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  11. F A Ayuk
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  12. M H J van Oers
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  13. A Nagler
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  14. L F Verdonck
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  15. H M Lokhorst
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Correspondence to H M Lokhorst.

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van de Donk, N., Kröger, N., Hegenbart, U. et al. Prognostic factors for donor lymphocyte infusions following non-myeloablative allogeneic stem cell transplantation in multiple myeloma. Bone Marrow Transplant 37, 1135–1141 (2006). https://doi.org/10.1038/sj.bmt.1705393

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  • DOI: https://doi.org/10.1038/sj.bmt.1705393

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