Allogeneic stem cell transplantation and donor lymphocyte infusions for chronic myelomonocytic leukemia
Prognosis in chronic myelomonocytic leukemia (CMML) is unfavorable and the optimal therapy remains uncertain. Currently, allogeneic stem cell transplantation is the only known curative therapeutic option. However, the data available are limited and restricted to small retrospective series. There is...
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2006-06, Vol.37 (11), p.1003-1008 |
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| creator | ELLIOTT, M. A TEFFERI, A LACY, M. Q MICALLEF, I. N PORRATA, L. F LITZOW, M. R HOGAN, W. J LETENDRE, L GASTINEAU, D. A ANSELL, S. M DISPENZIERI, A GERTZ, M. A HAYMAN, S. R INWARDS, D. J |
| description | Prognosis in chronic myelomonocytic leukemia (CMML) is unfavorable and the optimal therapy remains uncertain. Currently, allogeneic stem cell transplantation is the only known curative therapeutic option. However, the data available are limited and restricted to small retrospective series. There is even less information on the use of donor lymphocyte infusions (DLI) for this disease. We reviewed our experience of allogeneic stem cell transplantation and DLI for adults with CMML. Seventeen consecutive adults underwent allogeneic stem cell transplantation from related (n=14) or unrelated (n=3) donors. Median age was 50 years (range 26-60). Seven patients (41%) demonstrated relapse or persistent disease at a median of 6 months (range 3-55.5). Five patients underwent DLI for morphologic relapse and one for mixed donor chimerism. Two patients achieved durable complete remissions of 15 months each. The overall transplant-related mortality was 41% (n=7). With a median follow-up of 34.5 months, three patients (18%) currently remain alive and in continuous CR. The current study demonstrates a graft-versus-leukemia effect in CMML, both for allogeneic stem cell transplantation and for DLI. Nevertheless, consistent with reported experience of others, overall outcomes remain less than optimal and unpredictable. |
| doi_str_mv | 10.1038/sj.bmt.1705369 |
| format | Article |
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A ; TEFFERI, A ; LACY, M. Q ; MICALLEF, I. N ; PORRATA, L. F ; LITZOW, M. R ; HOGAN, W. J ; LETENDRE, L ; GASTINEAU, D. A ; ANSELL, S. M ; DISPENZIERI, A ; GERTZ, M. A ; HAYMAN, S. R ; INWARDS, D. J</creator><creatorcontrib>ELLIOTT, M. A ; TEFFERI, A ; LACY, M. Q ; MICALLEF, I. N ; PORRATA, L. F ; LITZOW, M. R ; HOGAN, W. J ; LETENDRE, L ; GASTINEAU, D. A ; ANSELL, S. M ; DISPENZIERI, A ; GERTZ, M. A ; HAYMAN, S. R ; INWARDS, D. J</creatorcontrib><description>Prognosis in chronic myelomonocytic leukemia (CMML) is unfavorable and the optimal therapy remains uncertain. Currently, allogeneic stem cell transplantation is the only known curative therapeutic option. However, the data available are limited and restricted to small retrospective series. There is even less information on the use of donor lymphocyte infusions (DLI) for this disease. We reviewed our experience of allogeneic stem cell transplantation and DLI for adults with CMML. Seventeen consecutive adults underwent allogeneic stem cell transplantation from related (n=14) or unrelated (n=3) donors. Median age was 50 years (range 26-60). Seven patients (41%) demonstrated relapse or persistent disease at a median of 6 months (range 3-55.5). Five patients underwent DLI for morphologic relapse and one for mixed donor chimerism. Two patients achieved durable complete remissions of 15 months each. The overall transplant-related mortality was 41% (n=7). With a median follow-up of 34.5 months, three patients (18%) currently remain alive and in continuous CR. The current study demonstrates a graft-versus-leukemia effect in CMML, both for allogeneic stem cell transplantation and for DLI. Nevertheless, consistent with reported experience of others, overall outcomes remain less than optimal and unpredictable.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/sj.bmt.1705369</identifier><identifier>PMID: 16604096</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>Basingstoke: Nature Publishing Group</publisher><subject>Adult ; Adults ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Bone marrow ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Care and treatment ; Chimerism ; Chronic myeloid leukemia ; Chronic myelomonocytic leukemia ; Female ; Graft Survival ; Graft vs Host Disease - etiology ; Graft vs Leukemia Effect ; Graft-versus-leukemia reaction ; Hematopoietic Stem Cell Transplantation - adverse effects ; Hematopoietic Stem Cell Transplantation - mortality ; Humans ; Leukemia ; Leukemia, Myelomonocytic, Chronic - mortality ; Leukemia, Myelomonocytic, Chronic - therapy ; Lymphocyte Transfusion ; Lymphocytes ; Male ; Medical sciences ; Middle Aged ; Myelomonocytic leukemia ; Prognosis ; Recurrence ; Retrospective Studies ; Stem cell transplantation ; Stem cells ; Survival Rate ; Tissue Donors ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation ; Transplantation, Homologous</subject><ispartof>Bone marrow transplantation (Basingstoke), 2006-06, Vol.37 (11), p.1003-1008</ispartof><rights>2006 INIST-CNRS</rights><rights>COPYRIGHT 2006 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Jun 2006</rights><rights>Nature Publishing Group 2006.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c635t-52a4a74eeef4a819e1ce7e51c88606eeef040eb9a1e0a228bbd5cc899fd49893</citedby><cites>FETCH-LOGICAL-c635t-52a4a74eeef4a819e1ce7e51c88606eeef040eb9a1e0a228bbd5cc899fd49893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2727,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17788373$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16604096$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ELLIOTT, M. A</creatorcontrib><creatorcontrib>TEFFERI, A</creatorcontrib><creatorcontrib>LACY, M. Q</creatorcontrib><creatorcontrib>MICALLEF, I. N</creatorcontrib><creatorcontrib>PORRATA, L. F</creatorcontrib><creatorcontrib>LITZOW, M. R</creatorcontrib><creatorcontrib>HOGAN, W. J</creatorcontrib><creatorcontrib>LETENDRE, L</creatorcontrib><creatorcontrib>GASTINEAU, D. A</creatorcontrib><creatorcontrib>ANSELL, S. M</creatorcontrib><creatorcontrib>DISPENZIERI, A</creatorcontrib><creatorcontrib>GERTZ, M. A</creatorcontrib><creatorcontrib>HAYMAN, S. R</creatorcontrib><creatorcontrib>INWARDS, D. J</creatorcontrib><title>Allogeneic stem cell transplantation and donor lymphocyte infusions for chronic myelomonocytic leukemia</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><description>Prognosis in chronic myelomonocytic leukemia (CMML) is unfavorable and the optimal therapy remains uncertain. Currently, allogeneic stem cell transplantation is the only known curative therapeutic option. However, the data available are limited and restricted to small retrospective series. There is even less information on the use of donor lymphocyte infusions (DLI) for this disease. We reviewed our experience of allogeneic stem cell transplantation and DLI for adults with CMML. Seventeen consecutive adults underwent allogeneic stem cell transplantation from related (n=14) or unrelated (n=3) donors. Median age was 50 years (range 26-60). Seven patients (41%) demonstrated relapse or persistent disease at a median of 6 months (range 3-55.5). Five patients underwent DLI for morphologic relapse and one for mixed donor chimerism. Two patients achieved durable complete remissions of 15 months each. The overall transplant-related mortality was 41% (n=7). With a median follow-up of 34.5 months, three patients (18%) currently remain alive and in continuous CR. The current study demonstrates a graft-versus-leukemia effect in CMML, both for allogeneic stem cell transplantation and for DLI. Nevertheless, consistent with reported experience of others, overall outcomes remain less than optimal and unpredictable.</description><subject>Adult</subject><subject>Adults</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Bone marrow</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Care and treatment</subject><subject>Chimerism</subject><subject>Chronic myeloid leukemia</subject><subject>Chronic myelomonocytic leukemia</subject><subject>Female</subject><subject>Graft Survival</subject><subject>Graft vs Host Disease - etiology</subject><subject>Graft vs Leukemia Effect</subject><subject>Graft-versus-leukemia reaction</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Hematopoietic Stem Cell Transplantation - mortality</subject><subject>Humans</subject><subject>Leukemia</subject><subject>Leukemia, Myelomonocytic, Chronic - mortality</subject><subject>Leukemia, Myelomonocytic, Chronic - therapy</subject><subject>Lymphocyte Transfusion</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myelomonocytic leukemia</subject><subject>Prognosis</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Survival Rate</subject><subject>Tissue Donors</subject><subject>Transfusions. 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A</au><au>TEFFERI, A</au><au>LACY, M. Q</au><au>MICALLEF, I. N</au><au>PORRATA, L. F</au><au>LITZOW, M. R</au><au>HOGAN, W. J</au><au>LETENDRE, L</au><au>GASTINEAU, D. A</au><au>ANSELL, S. M</au><au>DISPENZIERI, A</au><au>GERTZ, M. A</au><au>HAYMAN, S. R</au><au>INWARDS, D. J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Allogeneic stem cell transplantation and donor lymphocyte infusions for chronic myelomonocytic leukemia</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><addtitle>Bone Marrow Transplant</addtitle><date>2006-06-01</date><risdate>2006</risdate><volume>37</volume><issue>11</issue><spage>1003</spage><epage>1008</epage><pages>1003-1008</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><coden>BMTRE9</coden><abstract>Prognosis in chronic myelomonocytic leukemia (CMML) is unfavorable and the optimal therapy remains uncertain. Currently, allogeneic stem cell transplantation is the only known curative therapeutic option. However, the data available are limited and restricted to small retrospective series. There is even less information on the use of donor lymphocyte infusions (DLI) for this disease. We reviewed our experience of allogeneic stem cell transplantation and DLI for adults with CMML. Seventeen consecutive adults underwent allogeneic stem cell transplantation from related (n=14) or unrelated (n=3) donors. Median age was 50 years (range 26-60). Seven patients (41%) demonstrated relapse or persistent disease at a median of 6 months (range 3-55.5). Five patients underwent DLI for morphologic relapse and one for mixed donor chimerism. Two patients achieved durable complete remissions of 15 months each. The overall transplant-related mortality was 41% (n=7). With a median follow-up of 34.5 months, three patients (18%) currently remain alive and in continuous CR. The current study demonstrates a graft-versus-leukemia effect in CMML, both for allogeneic stem cell transplantation and for DLI. Nevertheless, consistent with reported experience of others, overall outcomes remain less than optimal and unpredictable.</abstract><cop>Basingstoke</cop><pub>Nature Publishing Group</pub><pmid>16604096</pmid><doi>10.1038/sj.bmt.1705369</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Nature; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Adults Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Bone marrow Bone marrow, stem cells transplantation. Graft versus host reaction Care and treatment Chimerism Chronic myeloid leukemia Chronic myelomonocytic leukemia Female Graft Survival Graft vs Host Disease - etiology Graft vs Leukemia Effect Graft-versus-leukemia reaction Hematopoietic Stem Cell Transplantation - adverse effects Hematopoietic Stem Cell Transplantation - mortality Humans Leukemia Leukemia, Myelomonocytic, Chronic - mortality Leukemia, Myelomonocytic, Chronic - therapy Lymphocyte Transfusion Lymphocytes Male Medical sciences Middle Aged Myelomonocytic leukemia Prognosis Recurrence Retrospective Studies Stem cell transplantation Stem cells Survival Rate Tissue Donors Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation Transplantation, Homologous |
| title | Allogeneic stem cell transplantation and donor lymphocyte infusions for chronic myelomonocytic leukemia |
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