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

Michelle A. Elliott, A. Tefferi, W. J. Hogan, L. Letendre, D. A. Gastineau, S. M. Ansell, A. Dispenzieri, M. A. Gertz, S. R. Hayman, D. J. Inwards, M. Q. Lacy, I. N. Micallef, L. F. Porrata, M. R. Litzow

Research output: Contribution to journalReview articlepeer-review

45 Scopus citations

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 1 2006

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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