Prophylactic T cell infusion after T cell-depleted bone marrow transplantation in patients with refractory lymphoma

C. K. Lee, M. de Magalhaes-Silverman, Raymond Hohl, M. Hayashi, J. Buatti, B. C. Wen, A. Schlueter, R. G. Strauss, R. D. Gingrich

Research output: Contribution to journalArticle

Abstract

Fifty-two patients with refractory lymphoma were prospectively treated with prophylactic T lymphocyte infusion after T cell-depleted allogeneic bone marrow transplantation, to induce graft-versus-lymphoma effect. Thirty-three patients had related donors; 19 had unrelated donors. After transplantation with marrow that had 0.8 ± 0.4 × 105 CD3+ cells/kg, T cells up to 1.75 × 106 CD3+ cells/kg were given over 3 months provided ≥ grade II acute graft-versus-host disease (GVHD) was not seen. The cumulative incidence of grades II-IV acute GVHD was 69%. Twenty of 32 evaluable patients (63%) developed chronic GVHD. Ten patients (19%) died of GVHD. The Kaplan-Meier 5-year overall survival of all patients was 34%. On multivariate analyses, chronic GVHD was significant for relapse (hazard ratio of 1.7, P < 0.05), and for overall survival (hazard ratio 1.4, P< 0.001). Chemosensitivity was significant for relapse only on univariate analysis. Patients who developed chronic GVHD had 4 years median survival, compared with 9 months in patients without chronic GVHD, P < 0.001. The study shows that patients with chronic GVHD have superior survivals, most probably related to a graft-versus-lymphoma effect, which could be modulated by prophylactic T cell infusion.

Original languageEnglish (US)
Pages (from-to)615-620
Number of pages6
JournalBone Marrow Transplantation
Volume29
Issue number7
DOIs
StatePublished - Jun 1 2002

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Graft vs Host Disease
Bone Marrow Transplantation
Lymphoma
T-Lymphocytes
Survival
Transplants
Recurrence
Unrelated Donors
Homologous Transplantation
Multivariate Analysis
Transplantation
Bone Marrow
Tissue Donors
Incidence

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Lee, C. K. ; de Magalhaes-Silverman, M. ; Hohl, Raymond ; Hayashi, M. ; Buatti, J. ; Wen, B. C. ; Schlueter, A. ; Strauss, R. G. ; Gingrich, R. D. / Prophylactic T cell infusion after T cell-depleted bone marrow transplantation in patients with refractory lymphoma. In: Bone Marrow Transplantation. 2002 ; Vol. 29, No. 7. pp. 615-620.
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Lee, CK, de Magalhaes-Silverman, M, Hohl, R, Hayashi, M, Buatti, J, Wen, BC, Schlueter, A, Strauss, RG & Gingrich, RD 2002, 'Prophylactic T cell infusion after T cell-depleted bone marrow transplantation in patients with refractory lymphoma', Bone Marrow Transplantation, vol. 29, no. 7, pp. 615-620. https://doi.org/10.1038/sj/bmt/1703426

Prophylactic T cell infusion after T cell-depleted bone marrow transplantation in patients with refractory lymphoma. / Lee, C. K.; de Magalhaes-Silverman, M.; Hohl, Raymond; Hayashi, M.; Buatti, J.; Wen, B. C.; Schlueter, A.; Strauss, R. G.; Gingrich, R. D.

In: Bone Marrow Transplantation, Vol. 29, No. 7, 01.06.2002, p. 615-620.

Research output: Contribution to journalArticle

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AU - de Magalhaes-Silverman, M.

AU - Hohl, Raymond

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AU - Buatti, J.

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AU - Gingrich, R. D.

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AB - Fifty-two patients with refractory lymphoma were prospectively treated with prophylactic T lymphocyte infusion after T cell-depleted allogeneic bone marrow transplantation, to induce graft-versus-lymphoma effect. Thirty-three patients had related donors; 19 had unrelated donors. After transplantation with marrow that had 0.8 ± 0.4 × 105 CD3+ cells/kg, T cells up to 1.75 × 106 CD3+ cells/kg were given over 3 months provided ≥ grade II acute graft-versus-host disease (GVHD) was not seen. The cumulative incidence of grades II-IV acute GVHD was 69%. Twenty of 32 evaluable patients (63%) developed chronic GVHD. Ten patients (19%) died of GVHD. The Kaplan-Meier 5-year overall survival of all patients was 34%. On multivariate analyses, chronic GVHD was significant for relapse (hazard ratio of 1.7, P < 0.05), and for overall survival (hazard ratio 1.4, P< 0.001). Chemosensitivity was significant for relapse only on univariate analysis. Patients who developed chronic GVHD had 4 years median survival, compared with 9 months in patients without chronic GVHD, P < 0.001. The study shows that patients with chronic GVHD have superior survivals, most probably related to a graft-versus-lymphoma effect, which could be modulated by prophylactic T cell infusion.

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