       Document 0572
 DOCN  M9630572
 TI    CD8-depleted donor lymphocyte infusion as treatment for relapsed chronic
       myelogenous leukemia after allogeneic bone marrow transplantation.
 DT    9603
 AU    Giralt S; Hester J; Huh Y; Hirsch-Ginsberg C; Rondon G; Seong D; Lee M;
       Gajewski J; Van Besien K; Khouri I; et al; Department of Hematology,
       University of Texas M.D. Anderson; Cancer Center, Houston 77031, USA.
 SO    Blood. 1995 Dec 1;86(11):4337-43. Unique Identifier : AIDSLINE
       MED/96082192
 AB    Donor lymphocyte infusions can reinduce complete remission in the
       majority of patients with chronic myelogenous leukemia (CML) who relapse
       into chronic phase after allogeneic bone marrow transplantation (BMT).
       Such infusions are associated with a high incidence of graft-versus-host
       disease (GVHD) and marrow aplasia. BMT using selective depletion of CD8+
       lymphocytes from donor cells reduces the incidence of GVHD without an
       increase in leukemia relapse. We hypothesized that infusion of
       CD8-depleted donor peripheral blood lymphocytes could also reinduce
       complete remissions with a lesser potential to produce symptomatic GVHD
       in patients with CML who relapsed after allogeneic BMT. Ten patients
       with Ph(+) CML who relapsed a median of 353 days after BMT (range, 82 to
       1,096 days) received donor lymphocyte infusions depleted of CD8+ cells.
       Nine patients received a single infusion and 1 received two infusions.
       Four patients were treated while in chronic phase with clonal evolution,
       2 during accelerated phase, 3 during blast crisis, and 1 in a
       cytogenetic relapse. A mean of 0.9 +/- 0.3 x 10(8) mononuclear cells/kg
       were infused, containing 0.6 +/- 0.4 x 10(6) CD3+CD8+ cells/kg. Six
       patients achieved hematologic and cytogenetic remission at 4, 8, 11, 15,
       39, and 54 weeks after lymphocyte infusion. Two patients developed > or
       = grade II acute GVHD, and 1 patient developed mild chronic GVHD. We
       conclude that donor lymphocyte infusions depleted of CD8+ cells can
       induce remissions with a low rate of severe acute GVHD in patients with
       CML who relapse after allogeneic BMT, supporting the hypothesis that
       CD8+ lymphocytes are important effectors of GVHD, but may not be
       essential for the graft-versus-leukemia effect against this disease.
       Further controlled studies are required to confirm these preliminary
       observations.
 DE    Acute Disease  Adult  *Bone Marrow Transplantation  Chimera  Chronic
       Disease  CD8-Positive T-Lymphocytes  Female  Graft vs Host
       Disease/ETIOLOGY/PREVENTION & CONTROL  Human  Leukemia, Myeloid,
       Chronic/*THERAPY  Lymphocyte Depletion  *Lymphocyte Transfusion  Male
       Middle Age  Recurrence  Tissue Donors  Transplantation, Homologous
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

