Donor lymphocyte infusions (DLI) can induce remissions in @entity1 who have relapsed after allogeneic bone marrow transplantation (BMT). However, DLI frequently also result in significant @entity2132 ( @entity2132 ). Several clinical and experimental lines of evidence have suggested that @entity405 (+) T cells play a critical role in the pathogenesis of @entity2132 . To develop methods to reduce the incidence of @entity2132 associated with DLI, we administered defined numbers of @entity404 (+) donor T cells after ex vivo depletion of @entity405 (+) lymphocytes to 40 @entity1 with relapsed @entity1583 after allogeneic BMT. Cohorts of @entity1 received 0.3, 1.0, or 1.5 x 10(8) @entity404 (+) cells/kg. Overall, 12 of 38 @entity1 (32%) evaluable for @entity137 developed @entity2132 . However, 6 of 27 @entity1 (22%) receiving 0.3 x 10(8) @entity404 cells/kg developed @entity2132 compared with 6 of 11 @entity1 (55%) who received >/=1.0 x 10(8) @entity404 cells/kg (P = .07). Treatment-related mortality was low (3%), with 1 death related to @entity281 in the setting of immunosuppression for @entity2132 . Disease responses after @entity404 (+) DLI were documented in 15 of 19 @entity1 (79%) with early-phase @entity1860 ( @entity1860 ) relapse, 5 of 6 @entity1 (83%) with relapsed @entity1582 , and 1 @entity1 with @entity2590 . For @entity1 with early-phase @entity1860 relapse, the Kaplan-Meier probability of achieving complete cytogenetic remission was 87% and the probability of complete molecular response was 78% at 1 year after DLI. The median time to complete cytogenetic response and molecular response in @entity1 with @entity1860 was 13 weeks (range, 9 to 30 weeks) and 34 weeks (range, 10 to 56 weeks), respectively. The median time to response in @entity1 with @entity1582 was 26 weeks (range, 15 to 62 weeks). All @entity1 in this trial who developed @entity2132 demonstrated @entity5 regression, but the presence of @entity2132 was not required for @entity1 to achieve a response, because 48% of responding @entity1 never developed evidence of @entity2132 . Two @entity1 with @entity1860 who did not respond at dose level 1 subsequently achieved complete cytogenetic remission after a second infusion of @entity405 -depleted cells at dose level 2. In @entity1 with evidence of mixed hematopoietic chimerism who achieved a complete remission after DLI, cytogenetic analysis of marrow cells also demonstrated conversion to complete donor hematopoiesis in all evaluable @entity1 . These studies suggest that relatively low numbers of @entity405 -depleted donor lymphocytes are effective in inducing complete remissions in @entity1 with stable-phase @entity1860 and @entity1582 who have relapsed after allogeneic BMT. Because of the relatively low risk of @entity137 associated with the infusion of defined numbers of @entity404 (+) donor cells, further studies can be undertaken in the setting of persistent minimal @entity66 to prevent relapse after allogeneic BMT.

@entity137 and efficacy of defined doses of XXXX (+) donor lymphocytes for treatment of relapse after allogeneic bone marrow transplant.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity404 :: ('920', 'Gene') :: ['CD4'] @entity66 :: ('MESH:D004194', 'Disease') :: ['residual disease'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity2590 :: ('MESH:D009190', 'Disease') :: ['myelodysplasia'] @entity1582 :: ('MESH:D009101', 'Disease') :: ['multiple myeloma'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection'] @entity2132 :: ('MESH:D006086', 'Disease') :: ['GVHD', 'acute or chronic GVHD', 'acute and/or chronic graft-versus-host disease'] @entity1583 :: ('MESH:D019337', 'Disease') :: ['hematologic malignancies'] @entity405 :: ('925', 'Gene') :: ['CD8'] @entity1860 :: ('MESH:D015464', 'Disease') :: ['CML', 'chronic myelogenous leukemia']
@entity404 :: (920,Gene) :: ['CD4']
