IMPACT OF DONOR LYMPHOCYTE INFUSIONS ON MYELOMA PATIENTS

Project: Research project

Project Details

Description

DESCRIPTION: (Applicant's Abstract) The applicant's primary hypothesis is that
the T cell component of the immune response will be important in the induction
of a clinical response to donor lymphocyte infusions (DLI) in multiple myeloma
(MM). It is important to characterize the T cell compartments that may
contribute to the response and also to evaluate approaches that promote their
reactivity to the myeloma clone. In relapsed post-allo-bone marrow
transplantation (BMT) patients entering the ECOG phase II DLI clinical protocol
(E1A97), the source of tumor antigen remains and can still serve to stimulate
donor T cells. Study of MM patients' T cell antimyeloma functions, T cell
phenotype, blood idiotype-specific T cells and T cell repertoire post-allo-BMT
but prior to DLI will tell us about their baseline immune status. Sequential T
cell studies after the DLI will be informative for any amplification of the
cellular immune response, and stability of that amplification. Additional
comparisons between the changes in blood T cell parameters and changes in the
level of clonal B cells measured by the MIg response, by flow cytometry, and by
PCR will enable the applicant to examine any association between T cell
reactivity and clinical response. This application is designed to provide a
unique laboratory investigation of the immune T cell status of MM patients.
Since the evidence is incomplete regarding the clinical importance of the T
cells to the growth and viability of the malignant clone after DLI, the
applicant will utilize the DLI clinical protocol to help better define the
relevant donor T cell immune component in MM patients. In addition, he will
identify patient subsets on the basis of their immune T cell response, who may
be more responsive to the new approach of post-Allo BMT DLI treatment. Finally,
if DLI is found to be associated with both a T cell response and clinically
significant responses he will have improved insight into the mechanism of DLI
efficacy.
StatusFinished
Effective start/end date4/1/003/31/04

ASJC

  • Medicine(all)