Details

Autor(en) / Beteiligte

• Bishop, M.R.
• Dean, R.M.
• Steinberg, S.M.
• Odom, J.
• Pavletic, S.Z.
• Chow, C.
• Pittaluga, S.
• Sportes, C.
• Hardy, N.M.
• Gea-Banacloche, J.
• Kolstad, A.
• Gress, R.E.
• Fowler, D.H.

Titel

Clinical evidence of a graft-versus-lymphoma effect against relapsed diffuse large B-cell lymphoma after allogeneic hematopoietic stem-cell transplantation

Ist Teil von

• Annals of oncology, 2008-11, Vol.19 (11), p.1935-1940

Ort / Verlag

Oxford: Elsevier Ltd

Erscheinungsjahr

2008

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• A graft-versus-lymphoma effect against diffuse large B-cell lymphoma (DLBCL) is inferred by sustained relapse-free survival after allogeneic stem-cell transplantation; however, there are limited data on a direct graft-versus-lymphoma effect against DLBCL following immunotherapeutic intervention by either withdrawal of immunosuppression or donor lymphocyte infusion (DLI). An analysis was carried out to determine whether a direct graft-versus-lymphoma effect exists against DLBCL. The analysis was restricted to patients with DLBCL, who were either not in complete remission at day +100 after allogeneic stem-cell transplantation or subsequently relapsed beyond this time point. Fifteen patients were identified as either not in complete remission (n=13) at their day +100 evaluation or subsequently relapsed (n=2) and were assessed for subsequent responses after withdrawal of immunosuppression or DLI. Eleven patients were treated with either withdrawal of immunosuppression (n=10) or a DLI (n=1) alone; four patients received chemotherapy with DLI to reduce tumor bulk. Nine (60%) patients subsequently responded (complete=8, partial=1). Six responses occurred after withdrawal of immunosuppression alone. Six patients are alive (range 42–83+ months) in complete remission without further treatment. The demonstration of sustained complete remission following immunotherapeutic intervention provides direct evidence of a graft-versus-lymphoma effect against DLBCL.