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 language | English (US) |
|---|---|
| Pages (from-to) | 1003-1008 |
| Number of pages | 6 |
| Journal | Bone Marrow Transplantation |
| Volume | 37 |
| Issue number | 11 |
| DOIs | |
| State | Published - Jun 2006 |
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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 journal › Article
}
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
VL - 37
SP - 1003
EP - 1008
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
SN - 0268-3369
IS - 11
ER -