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Donor leukocyte infusions for multiple myeloma.
M Salama1, T Nevill, D Marcellus
1University of Texas Southwestern Medical Center, Dallas 75390-8852, USA.
Bone Marrow Transplantation
|January 10, 2001
Summary
Donor leukocyte infusion (DLI) shows anti-myeloma activity in multiple myeloma (MM) patients post-allogeneic BMT. However, responses are often short-lived, and graft-versus-host disease (GVHD) affects most responders.
Area of Science:
- Hematology
- Immunotherapy
- Oncology
Background:
- Donor leukocyte infusion (DLI) is established for chronic myeloid leukemia (CML).
- Its efficacy in other hematologic malignancies, like multiple myeloma (MM), requires further investigation.
Purpose of the Study:
- To evaluate the effectiveness and safety of DLI in patients with multiple myeloma (MM).
Main Methods:
- Retrospective analysis of 25 MM patients treated with DLI after allogeneic bone marrow transplantation (BMT).
- DLI administered from original marrow donors; chemotherapy used in some cases.
- Assessment of response rates, duration of response, and incidence of graft-versus-host disease (GVHD).
Main Results:
- Overall response observed in 8 of 25 patients (32%), with 5 achieving complete or partial responses after additional DLIs.
- All responders developed acute or chronic GVHD.
- No cases of post-DLI pancytopenia were reported.
- Response duration varied, with some lasting over a year and others less than a year.
Conclusions:
- DLI demonstrates anti-myeloma activity.
- The therapeutic benefit is limited by a significant proportion of non-responders or those with short response durations.
- High incidence of GVHD in responders is a major concern.