Clinical evidence of a graft-versus-lymphoma effect against relapsed diffuse large B-cell lymphoma after allogeneic hematopoietic stem-cell transplantation

M. R. Bishop, R. M. Dean, S. M. Steinberg, J. Odom, S. Z. Pavletic, C. Chow, S. Pittaluga, C. Sportes, N. M. Hardy, J. Gea-Banacloche, A. Kolstad, R. E. Gress, D. H. Fowler

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Abstract

Background: A graft-versus-lymphoma effect against diffuse large B-cell lymphoma (DLBCL) is inferred by sustained relapse-free survival after allogeneic stem-cell transplantation; however, there are limited data on a direct graft-versus-lymphoma effect against DLBCL following immunotherapeutic intervention by either withdrawal of immunosuppression or donor lymphocyte infusion (DLI). Materials and methods: An analysis was carried out to determine whether a direct graft-versus-lymphoma effect exists against DLBCL. The analysis was restricted to patients with DLBCL, who were either not in complete remission at day +100 after allogeneic stem-cell transplantation or subsequently relapsed beyond this time point. Results: Fifteen patients were identified as either not in complete remission (n = 13) at their day +100 evaluation or subsequently relapsed (n = 2) and were assessed for subsequent responses after withdrawal of immunosuppression or DLI. Eleven patients were treated with either withdrawal of immunosuppression (n = 10) or a DLI (n = 1) alone; four patients received chemotherapy with DLI to reduce tumor bulk. Nine (60%) patients subsequently responded (complete = 8, partial = 1). Six responses occurred after withdrawal of immunosuppression alone. Six patients are alive (range 42-83+ months) in complete remission without further treatment. Conclusion: The demonstration of sustained complete remission following immunotherapeutic intervention provides direct evidence of a graft-versus-lymphoma effect against DLBCL.

Original languageEnglish (US)
Pages (from-to)1935-1940
Number of pages6
JournalAnnals of Oncology
Volume19
Issue number11
DOIs
StatePublished - Nov 3 2008

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Keywords

  • Allogeneic
  • Diffuse large B-cell lymphoma
  • Graft-versus-lymphoma

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Bishop, M. R., Dean, R. M., Steinberg, S. M., Odom, J., Pavletic, S. Z., Chow, C., Pittaluga, S., Sportes, C., Hardy, N. M., Gea-Banacloche, J., Kolstad, A., Gress, R. E., & Fowler, D. H. (2008). Clinical evidence of a graft-versus-lymphoma effect against relapsed diffuse large B-cell lymphoma after allogeneic hematopoietic stem-cell transplantation. Annals of Oncology, 19(11), 1935-1940. https://doi.org/10.1093/annonc/mdn404