TY - JOUR
T1 - Long term disease-free survival in acute leukemia patients recovering with increased γδ T cells after partially mismatched related donor bone marrow transplantation
AU - Godder, K. T.
AU - Henslee-Downey, P. J.
AU - Mehta, J.
AU - Park, B. S.
AU - Chiang, K. Y.
AU - Abhyankar, S.
AU - Lamb, L. S.
N1 - Funding Information:
This study was supported by NIH NCI R21 CA 76667 and Leukemia and Lymphoma Society 6507. The study was presented in part at the ASH meeting 2002 and ASCO meeting 2003.
PY - 2007/6
Y1 - 2007/6
N2 - Allogeneic stem cell transplantation (ASCT) has improved leukemia-free survival (LFS) in many but not all patients with acute leukemia. This is an eight-year follow-up to our previous study showing a survival advantage to patients with an increased γδ T cells following ASCT. γδ T cell levels were collected prospectively in 153 patients (acute lymphoblastic leukemia (ALL) n = 77; acute myelogenous leukemia (AML) n = 76) undergoing partially mismatched related donor ASCT. Median age was 22 years (1-59), and 62% of the patients were in relapse at transplant. Patient-donor human leukocyte antigen (HLA) disparity of three antigens was 37% in the graft-versus-host disease (GvHD) and 29% in the rejection directions. All patients received a partially T cell-depleted graft using T10B9 (n = 46) or OKT3 (n = 107). Five years LFS and overall survival (OS) of patients with increased γδ compared to those with normal/decreased numbers were 54.4 vs 19.1%; P < 0.0003, and 70.8 vs 19.6% P < 0.0001, respectively, with no difference in GvHD (P = 0.96). In a Cox multivariate analysis, normal/decreased γδ (hazard ratio (HR) 4.26, P = 0.0002) and sex mismatch (HR 1.45 P = 0.049) were associated with inferior LFS. In conclusion, γδ T cells may facilitate a graft-versus-leukemia (GvL) effect, without causing GvHD. Further evaluations of this effect may lead to specific immunotherapy for patients with refractory leukemia.
AB - Allogeneic stem cell transplantation (ASCT) has improved leukemia-free survival (LFS) in many but not all patients with acute leukemia. This is an eight-year follow-up to our previous study showing a survival advantage to patients with an increased γδ T cells following ASCT. γδ T cell levels were collected prospectively in 153 patients (acute lymphoblastic leukemia (ALL) n = 77; acute myelogenous leukemia (AML) n = 76) undergoing partially mismatched related donor ASCT. Median age was 22 years (1-59), and 62% of the patients were in relapse at transplant. Patient-donor human leukocyte antigen (HLA) disparity of three antigens was 37% in the graft-versus-host disease (GvHD) and 29% in the rejection directions. All patients received a partially T cell-depleted graft using T10B9 (n = 46) or OKT3 (n = 107). Five years LFS and overall survival (OS) of patients with increased γδ compared to those with normal/decreased numbers were 54.4 vs 19.1%; P < 0.0003, and 70.8 vs 19.6% P < 0.0001, respectively, with no difference in GvHD (P = 0.96). In a Cox multivariate analysis, normal/decreased γδ (hazard ratio (HR) 4.26, P = 0.0002) and sex mismatch (HR 1.45 P = 0.049) were associated with inferior LFS. In conclusion, γδ T cells may facilitate a graft-versus-leukemia (GvL) effect, without causing GvHD. Further evaluations of this effect may lead to specific immunotherapy for patients with refractory leukemia.
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U2 - 10.1038/sj.bmt.1705650
DO - 10.1038/sj.bmt.1705650
M3 - Article
C2 - 17450185
AN - SCOPUS:34250207973
SN - 0268-3369
VL - 39
SP - 751
EP - 757
JO - Bone marrow transplantation
JF - Bone marrow transplantation
IS - 12
ER -