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Adoptive immunotherapy for recurrent CML after BMT

C Helg1, E Roux, P Beris

  • 1Department of Medicine, University Hospital, Geneva, Switzerland.

Bone Marrow Transplantation
|August 1, 1993
PubMed
Summary
This summary is machine-generated.

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Donor peripheral blood mononuclear cell transfusions combined with interferon alpha 2 therapy effectively controlled chronic myeloid leukemia (CML) relapse after stem cell transplantation. This approach eradicated Philadelphia chromosome-positive cells in patients with CML.

Area of Science:

  • Hematology
  • Immunotherapy
  • Oncology

Background:

  • Chronic myeloid leukemia (CML) can relapse after T-cell depleted bone marrow (BM) transplantation.
  • Donor lymphocyte infusions are used to manage relapsed hematological malignancies.
  • Interferon alpha 2 (IFN alpha 2) has shown efficacy in CML treatment.

Purpose of the Study:

  • To evaluate the efficacy of donor peripheral blood mononuclear cell (PBMC) transfusions combined with IFN alpha 2 therapy in CML patients relapsed post-transplantation.
  • To assess the durability of response and identify potential adverse events.

Main Methods:

  • Three patients with CML relapsed after T-depleted HLA-identical sibling BM transplantation received PBMC transfusions and short-term IFN alpha 2 therapy.
  • Treatment response was monitored by cytogenetics (Philadelphia chromosome), PCR for bcr-abl transcripts, and assessment of recipient-derived hematological cells.

Related Experiment Videos

  • Patient monitoring included assessment for BM aplasia and donor-derived cell engraftment.

    • Main Results:

    • Complete remission was achieved in all three patients, evidenced by the disappearance of Philadelphia chromosome-positive cells within 90 days.
    • Highly sensitive PCR techniques detected no bcr-abl transcripts or recipient-derived hematological cells, indicating deep molecular remission.
    • Two patients in chronic phase remained disease-free at 300 and 360 days post-treatment.
    • One patient in accelerated phase died from BM aplasia 39 days after PBMC infusion, with pre-treatment failure to detect donor-derived granulocytes potentially indicating poor donor BM activity.

    Conclusions:

    • Combined PBMC transfusion and IFN alpha 2 therapy is a highly effective strategy for controlling CML relapse post-transplantation.
    • The absence of residual disease markers suggests potent anti-leukemic activity.
    • Monitoring for donor-derived cells may help predict and potentially prevent life-threatening BM aplasia following successful CML clearance.