PURPOSE: @entity1 with advanced @entity5 who experience relapse after allogeneic bone marrow transplantation (BMT) have a poor prognosis. Long-term survival after chemotherapy alone, second myeloablative transplant, or donor leukocyte infusions (DLIs) alone is unusual. DLIs may have minimal effectiveness in advanced disease because adequate cellular responses are not able to develop in the presence of bulky, fast-growing disease. A chemotherapy strategy was used to debulk disease before administration of @entity1261 ( @entity1261 )-primed DLIs. @entity1 AND METHODS: Sixty-five @entity1 experiencing hematologic relapse of @entity5 after HLA-matched sibling BMT were prospectively treated with @entity2592 -based chemotherapy, then @entity1261 -primed DLIs. No prophylactic immunosuppression was provided. RESULTS: Twenty-seven of 57 assessable @entity1 experienced a complete response. @entity2132 ( @entity2132 ) was observed in 56% of the @entity1 . Treatment-related mortality was 23%. Overall survival at 2 years for the entire cohort was 19%. @entity1 with a complete response were more likely to survive, with 1- and 2-year survival rates of 51% and 41%, respectively, with a median follow-up of more than 2 years. The 1-year survival for nonresponders was 5%. A posttransplant remission lasting more than 6 months before relapse was associated with a higher likelihood of response. @entity2132 was not required for durable remission. CONCLUSION: Salvage treatment with chemotherapy before DLI can help some @entity1 with advanced myeloid relapse and is not dependent on @entity2132 . @entity1 with short remissions after BMT are unlikely to benefit from this approach, and the approach is associated with significant treatment-related mortality. Modifications of this approach or entirely different approaches will be required for most @entity1 with this difficult clinical problem.

Prospective trial of chemotherapy and donor leukocyte infusions for relapse of advanced XXXX after allogeneic stem-cell transplantation.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity1261 :: ('1440', 'Gene') :: ['G-CSF', 'granulocyte colony-stimulating factor'] @entity5 :: ('MESH:D009369', 'Disease') :: ['myeloid malignancies', 'myeloid malignancy'] @entity2592 :: ('MESH:D003561', 'Chemical') :: ['cytarabine'] @entity2132 :: ('MESH:D006086', 'Disease') :: ['GVHD', 'Graft-versus-host disease']
@entity5 :: (MESH:D009369,Disease) :: ['myeloid malignancies']
