Klyuchnikov, Evgeny and Holler, Ernst and Bornhaeuser, Martin and Kobbe, Guido and Nagler, Arnon and Shimoni, Avichai and Koenecke, Christian and Wolschke, Christine and Bacher, Ulrike and Zander, Axel R. and Kroeger, Nicolaus (2012) Donor lymphocyte infusions and second transplantation as salvage treatment for relapsed myelofibrosis after reduced-intensity allografting. BRITISH JOURNAL OF HAEMATOLOGY, 159 (2). pp. 172-181. ISSN 0007-1048,
Full text not available from this repository. (Request a copy)Abstract
Thirty myelofibrosis patients (21 males, nine females) with relapse (n = 27) or graft-rejection (n = 3) after dose-reduced allografting underwent a salvage strategy including donor lymphocyte infusions (DLIs) and/or second allogeneic haematopoietic stem cell transplantation (HSCT). Twenty-six patients received a median number of three (range, 15) DLIs in a dose-escalated mode starting with a median dose of 1.2 x 106 (range, 0.0038 x 106) up to median dose of 40 x 106 T-cells/kg (range, 10130 x 106). 10/26 patients (39%) achieved complete response (CR) to DLIs. Acute (grade II-IV) and chronic graft-versus-host (GvHD) disease occurred in 12% and 36% cases. Thirteen non-responders to DLI and four patients who did not receive DLI due to graft-rejection or acute transformation of the blast phase underwent a second allogeneic HSCT from alternative (n = 15) or the same (n = 2) donor. One patient (6%) experienced primary graft-failure and died. Acute (II-IV) and chronic GvHD were observed in 47% and 46% of patients. Overall responses after second HSCT were seen in 12/15 patients (80%: CR: n = 9, partial response: n = 3). The 1-year cumulative incidence of non-relapse mortality for recipients of a second allograft was 6%, and the cumulative incidence of relapse was 24%. After a median follow-up of 27 months, the 2-year overall survival and progression-free survival for all 30 patients was 70% and 67%, respectively. In conclusion, our two-step strategy, including DLI and second HSCT for non-responding or ineligible patients, is an effective and well-tolerated salvage approach for patients relapsing after reduced-intensity allograft after myelofibrosis.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | STEM-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; CHRONIC MYELOID-LEUKEMIA; VERSUS-HOST-DISEASE; TYROSINE KINASE JAK2; LOW-DOSE THALIDOMIDE; IDIOPATHIC MYELOFIBROSIS; POLYCYTHEMIA-VERA; MYELOPROLIFERATIVE DISORDERS; ALLOGENEIC TRANSPLANTATION; myelofibrosis; relapse; donor lymphocyte infusions (DLIs); second allogeneic stem cell transplantation (HSCT); treosulfan |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 05 May 2020 10:05 |
| Last Modified: | 05 May 2020 10:05 |
| URI: | https://pred.uni-regensburg.de/id/eprint/18028 |
Actions (login required)
 |
View Item |
