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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Lymphoma, Large B-Cell, Diffuse
Hematopoietic Stem Cell Transplantation
Lymphoma
Transplants
Immunosuppression
Tissue Donors
Lymphocytes
Stem Cell Transplantation
Recurrence
Drug Therapy
Survival
Neoplasms

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

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

In: Annals of Oncology, Vol. 19, No. 11, 03.11.2008, p. 1935-1940.

Research output: Contribution to journalArticle

Bishop, MR, Dean, RM, Steinberg, SM, Odom, J, Pavletic, SZ, Chow, C, Pittaluga, S, Sportes, C, Hardy, NM, Gea-Banacloche, J, Kolstad, A, Gress, RE & Fowler, DH 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, vol. 19, no. 11, pp. 1935-1940. https://doi.org/10.1093/annonc/mdn404
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. / Clinical evidence of a graft-versus-lymphoma effect against relapsed diffuse large B-cell lymphoma after allogeneic hematopoietic stem-cell transplantation. In: Annals of Oncology. 2008 ; Vol. 19, No. 11. pp. 1935-1940.
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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.",
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AU - Bishop, M. R.

AU - Dean, R. M.

AU - Steinberg, S. M.

AU - Odom, J.

AU - Pavletic, S. Z.

AU - Chow, C.

AU - Pittaluga, S.

AU - Sportes, C.

AU - Hardy, N. M.

AU - Gea-Banacloche, J.

AU - Kolstad, A.

AU - Gress, R. E.

AU - Fowler, D. H.

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N2 - 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.

AB - 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.

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