Huang Xiaojun, Guo Nailan, Ren Hanyun, Zhang Yaochen, Gao Zhiyong, Lu Daopei
Institute of Hematology, People's Hospital, Peking University, Beijing 100044, China.
Chin Med J (Engl). 2003 May;116(5):736-41.
To observe the antileukemic effect in relapse patients by infusion of donor immunocompetent cells with or without granulocyte colony-stimulating factor (G-CSF) mobilization.
Twenty patients with leukemia in relapse after allogeneic bone marrow transplantation (allo-BMT) were treated with chemotherapy followed by donor-derived lymphocytes (DDL) without G-CSF mobilization (Group A, n = 11), or donor peripheral blood progenitor cells (PBPCs) with G-CSF mobilization (Group B, n = 9).
Five patients in Group A were in hematologic relapse. After DDL infusion, 3 of 5 patients had a temporary complete remission (CR) and relapsed after 3, 7 and 10 months, respectively. One achieved partial remission and died of interstitial pneumonia; and the other one showed no response. Another 6 patients in Group A were in cytogenetic relapse or central nerve system (CNS) leukemia, and all achieved CR and remained in disease free survival (DFS) for 10 to 98 months after DDL infusion. All 9 patients in group B were in hematologic relapse. Three patients with chronic myeloid leukemia (CML) had cytogenetic and molecular remission for 16, 35 and 51 months, respectively after PBPC infusion; and 5 patients with acute lymphoid leukemia (ALL) had CR and were still in CR for 10 to 18 months except 1 patient relapsed soon. And the other one with AML showed no response to the therapy.
Donor immunocompetent cells infusion is an effective therapy for relapsed leukemia after allo-BMT, especially for the patients with early (molecular and cytogenetic) or CNS relapse. Infusion of donor PBPC mobilized by G-CSF seems to have more potentiated graft-versus-leukemia (GVL) effect than DDL infusion.
观察输注供体免疫活性细胞联合或不联合粒细胞集落刺激因子（G-CSF）动员对复发患者的抗白血病作用。
20例异基因骨髓移植（allo-BMT）后复发的白血病患者接受化疗，随后分别接受未用G-CSF动员的供体来源淋巴细胞（DDL）治疗（A组，n = 11），或用G-CSF动员的供体外周血祖细胞（PBPC）治疗（B组，n = 9）。
A组5例患者发生血液学复发。输注DDL后，5例患者中有3例获得短暂完全缓解（CR），分别于3、7和10个月后复发。1例达到部分缓解，死于间质性肺炎；另1例无反应。A组另外6例患者发生细胞遗传学复发或中枢神经系统（CNS）白血病，输注DDL后均达到CR，无病生存（DFS）10至98个月。B组9例患者均发生血液学复发。3例慢性髓性白血病（CML）患者输注PBPC后分别获得16、35和51个月的细胞遗传学和分子学缓解；5例急性淋巴细胞白血病（ALL）患者达到CR，除1例很快复发外，其余仍处于CR状态10至18个月。另1例急性髓性白血病（AML）患者对治疗无反应。
输注供体免疫活性细胞是allo-BMT后复发白血病的有效治疗方法，尤其适用于早期（分子和细胞遗传学）或CNS复发的患者。G-CSF动员的供体PBPC输注似乎比DDL输注具有更强的移植物抗白血病（GVL）效应。
