Cytokine-mediated immunotherapy with or without donor leukocytes for poor-risk acute myeloid leukemia relapsing after allogeneic bone marrow transplantation

J. Mehta*, R. Powles, S. Singhal, D. Tait, J. Swansbury, J. Treleaven

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

Six patients with high-risk acute myeloid leukemia (AML) relapsing after allogeneic bone marrow transplantation (BMT) were treated with interferon-α2b to stimulate graft-versus-leukemia reactions. Additionally, donor mononuclear cells were infused with or without interleukin-2 as first-line treatment or upon failure of interferon-α2b in 5 patients. Two patients developed clinical acute graft-versus-host disease (GVHD) after a combination of donor leukocytes and interferon-α, and one developed de novo chronic GVHD after interleukin-2 and interferon-α. Complete remission was attained in 4 patients whereas 2 patients showed no response. Two of the responding patients relapsed rapidly. Four patients died of a combination of complications of immunotherapy and progressive disease. Two patients are alive in remission with chronic GVHD (Karnofsky performance scores of 80%) 8 and 18 months after immunotherapy. We conclude that cytokine-mediated immunotherapy with or without donor cell infusions may be effective in some cases of AML relapsing after allogeneic BMT, and may result in long-term survival. With limited data, it appears that development of chronic GVHD after immunotherapy is essential for continued remission.

Original languageEnglish (US)
Pages (from-to)133-137
Number of pages5
JournalBone Marrow Transplantation
Volume16
Issue number1
StatePublished - Aug 16 1995

Keywords

  • Acute myeloid leukemia
  • Allogeneic bone marrow transplantation
  • Graft-versus-leukemia reactions
  • Interferon-α
  • Interleukin-2
  • Leukocyte infusion

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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