Complete molecular responses are achieved after reduced intensity stem cell transplantation and donor lymphocyte infusion in chronic myeloid leukemia

• Published in: Blood Vol. 111; no. 10; pp. 5252 - 5255
• Main Authors: Heaney, Nicholas B., Copland, Mhairi, Stewart, Karen, Godden, Judith, Parker, Anne N., McQuaker, I. Grant, Smith, Graeme M., Crawley, Charles, Shepherd, Pat, Holyoake, Tessa L.
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 15-05-2008; The Americain Society of Hematology
• Subjects: Adult; Benzamides; Biological and medical sciences; Graft Survival; Graft vs Host Disease; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Transplantation - methods; Humans; Imatinib Mesylate; Length of Stay; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphocyte Transfusion - methods; Medical sciences; Middle Aged; Piperazines - therapeutic use; Pyrimidines - therapeutic use; Treatment Outcome; Virus Activation; Hematology; Donor lymphocyte infusion; Stem cell; Hematopoietic cell; Chronic myelogenous leukemia; Malignant hemopathy; Non myeloablative treatment; Myeloproliferative syndrome; Treatment; Donor; Immunotherapy; Graft; Adoptive immunization; Lymphocyte; Cancer
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2007-10-118141

Patients with newly diagnosed chronic phase chronic myeloid leukemia were treated with imatinib mesylate (IM) for 6 to 12 months to establish disease control, before reduced intensity stem cell transplantation (RISCT). Escalating doses of donor lymphocyte infusions were given from 6 months after transplantation to eradicate residual disease. A total of 18 patients entered the study and 15 received RISCT (median follow-up, 31 months). RISCT was well tolerated with rapid engraftment, short inpatient stays, and few readmissions. Viral reactivation was common, although extensive graft-versus-host disease occurred infrequently. Donor lymphocyte infusions were given as part of the RISCT protocol in 13 of 15 patients. BCR-ABL transcripts continued to decrease after RISCT, and 8 (53%) patients achieved sustained undetectable levels. All patients are currently off IM. Although IM is now established as first-line therapy for chronic phase chronic myeloid leukemia, this protocol is a safe, well-tolerated, and effective strategy in these patients. This study is registered at http://www.controlled-trials.com as ISRCTN86187144.