Allogeneic stem cell transplantation and donor lymphocyte infusions for chronic myelomonocytic leukemia

Michelle A. Elliott, Ayalew Tefferi, William Hogan, L. Letendre, D. A. Gastineau, Stephen Maxted Ansell, Angela Dispenzieri, Morie Gertz, S. R. Hayman, D. J. Inwards, Martha Lacy, Ivana Micallef, L. F. Porrata, Mark R Litzow

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Prognosis in chronic myelomonocytic leukemia (CMML) is unfavorable and the optimal therapy remains uncertain. Currently, allogeneic stem cell transplantation is the only known curative therapeutic option. However, the data available are limited and restricted to small retrospective series. There is even less information on the use of donor lymphocyte infusions (DLI) for this disease. We reviewed our experience of allogeneic stem cell transplantation and DLI for adults with CMML. Seventeen consecutive adults underwent allogeneic stem cell transplantation from related (n = 14) or unrelated (n = 3) donors. Median age was 50 years (range 26-60). Seven patients (41%) demonstrated relapse or persistent disease at a median of 6 months (range 3-55.5). Five patients underwent DLI for morphologic relapse and one for mixed donor chimerism. Two patients achieved durable complete remissions of 15 months each. The overall transplant-related mortality was 41% (n = 7). With a median follow-up of 34.5 months, three patients (18%) currently remain alive and in continuous CR. The current study demonstrates a graft-versus-leukemia effect in CMML, both for allogeneic stem cell transplantation and for DLI. Nevertheless, consistent with reported experience of others, overall outcomes remain less than optimal and unpredictable.

Original languageEnglish (US)
Pages (from-to)1003-1008
Number of pages6
JournalBone Marrow Transplantation
Volume37
Issue number11
DOIs
StatePublished - Jun 2006

Fingerprint

Leukemia, Myelomonocytic, Chronic
Stem Cell Transplantation
Tissue Donors
Lymphocytes
Transplants
Recurrence
Chimerism
Leukemia
Mortality
Therapeutics

Keywords

  • Allogeneic stem cell transplantation
  • Chronic myelomonocytic leukemia
  • Donor lymphocyte infusions

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Allogeneic stem cell transplantation and donor lymphocyte infusions for chronic myelomonocytic leukemia. / Elliott, Michelle A.; Tefferi, Ayalew; Hogan, William; Letendre, L.; Gastineau, D. A.; Ansell, Stephen Maxted; Dispenzieri, Angela; Gertz, Morie; Hayman, S. R.; Inwards, D. J.; Lacy, Martha; Micallef, Ivana; Porrata, L. F.; Litzow, Mark R.

In: Bone Marrow Transplantation, Vol. 37, No. 11, 06.2006, p. 1003-1008.

Research output: Contribution to journalArticle

@article{42a2ec7cc4d5459bb9035fabd82d8b54,
title = "Allogeneic stem cell transplantation and donor lymphocyte infusions for chronic myelomonocytic leukemia",
abstract = "Prognosis in chronic myelomonocytic leukemia (CMML) is unfavorable and the optimal therapy remains uncertain. Currently, allogeneic stem cell transplantation is the only known curative therapeutic option. However, the data available are limited and restricted to small retrospective series. There is even less information on the use of donor lymphocyte infusions (DLI) for this disease. We reviewed our experience of allogeneic stem cell transplantation and DLI for adults with CMML. Seventeen consecutive adults underwent allogeneic stem cell transplantation from related (n = 14) or unrelated (n = 3) donors. Median age was 50 years (range 26-60). Seven patients (41{\%}) demonstrated relapse or persistent disease at a median of 6 months (range 3-55.5). Five patients underwent DLI for morphologic relapse and one for mixed donor chimerism. Two patients achieved durable complete remissions of 15 months each. The overall transplant-related mortality was 41{\%} (n = 7). With a median follow-up of 34.5 months, three patients (18{\%}) currently remain alive and in continuous CR. The current study demonstrates a graft-versus-leukemia effect in CMML, both for allogeneic stem cell transplantation and for DLI. Nevertheless, consistent with reported experience of others, overall outcomes remain less than optimal and unpredictable.",
keywords = "Allogeneic stem cell transplantation, Chronic myelomonocytic leukemia, Donor lymphocyte infusions",
author = "Elliott, {Michelle A.} and Ayalew Tefferi and William Hogan and L. Letendre and Gastineau, {D. A.} and Ansell, {Stephen Maxted} and Angela Dispenzieri and Morie Gertz and Hayman, {S. R.} and Inwards, {D. J.} and Martha Lacy and Ivana Micallef and Porrata, {L. F.} and Litzow, {Mark R}",
year = "2006",
month = "6",
doi = "10.1038/sj.bmt.1705369",
language = "English (US)",
volume = "37",
pages = "1003--1008",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "11",

}

TY - JOUR

T1 - Allogeneic stem cell transplantation and donor lymphocyte infusions for chronic myelomonocytic leukemia

AU - Elliott, Michelle A.

AU - Tefferi, Ayalew

AU - Hogan, William

AU - Letendre, L.

AU - Gastineau, D. A.

AU - Ansell, Stephen Maxted

AU - Dispenzieri, Angela

AU - Gertz, Morie

AU - Hayman, S. R.

AU - Inwards, D. J.

AU - Lacy, Martha

AU - Micallef, Ivana

AU - Porrata, L. F.

AU - Litzow, Mark R

PY - 2006/6

Y1 - 2006/6

N2 - Prognosis in chronic myelomonocytic leukemia (CMML) is unfavorable and the optimal therapy remains uncertain. Currently, allogeneic stem cell transplantation is the only known curative therapeutic option. However, the data available are limited and restricted to small retrospective series. There is even less information on the use of donor lymphocyte infusions (DLI) for this disease. We reviewed our experience of allogeneic stem cell transplantation and DLI for adults with CMML. Seventeen consecutive adults underwent allogeneic stem cell transplantation from related (n = 14) or unrelated (n = 3) donors. Median age was 50 years (range 26-60). Seven patients (41%) demonstrated relapse or persistent disease at a median of 6 months (range 3-55.5). Five patients underwent DLI for morphologic relapse and one for mixed donor chimerism. Two patients achieved durable complete remissions of 15 months each. The overall transplant-related mortality was 41% (n = 7). With a median follow-up of 34.5 months, three patients (18%) currently remain alive and in continuous CR. The current study demonstrates a graft-versus-leukemia effect in CMML, both for allogeneic stem cell transplantation and for DLI. Nevertheless, consistent with reported experience of others, overall outcomes remain less than optimal and unpredictable.

AB - Prognosis in chronic myelomonocytic leukemia (CMML) is unfavorable and the optimal therapy remains uncertain. Currently, allogeneic stem cell transplantation is the only known curative therapeutic option. However, the data available are limited and restricted to small retrospective series. There is even less information on the use of donor lymphocyte infusions (DLI) for this disease. We reviewed our experience of allogeneic stem cell transplantation and DLI for adults with CMML. Seventeen consecutive adults underwent allogeneic stem cell transplantation from related (n = 14) or unrelated (n = 3) donors. Median age was 50 years (range 26-60). Seven patients (41%) demonstrated relapse or persistent disease at a median of 6 months (range 3-55.5). Five patients underwent DLI for morphologic relapse and one for mixed donor chimerism. Two patients achieved durable complete remissions of 15 months each. The overall transplant-related mortality was 41% (n = 7). With a median follow-up of 34.5 months, three patients (18%) currently remain alive and in continuous CR. The current study demonstrates a graft-versus-leukemia effect in CMML, both for allogeneic stem cell transplantation and for DLI. Nevertheless, consistent with reported experience of others, overall outcomes remain less than optimal and unpredictable.

KW - Allogeneic stem cell transplantation

KW - Chronic myelomonocytic leukemia

KW - Donor lymphocyte infusions

UR - http://www.scopus.com/inward/record.url?scp=33646809389&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646809389&partnerID=8YFLogxK

U2 - 10.1038/sj.bmt.1705369

DO - 10.1038/sj.bmt.1705369

M3 - Article

C2 - 16604096

AN - SCOPUS:33646809389

VL - 37

SP - 1003

EP - 1008

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 11

ER -