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KMID : 0391319930030020217
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Korean Journal of Biological Response Modifiers
1993 Volume.3 No. 2 p.217 ~ p.224
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Adoptive Immunotherapy & Induction of GvHD for Recurrent Leukemia Leukemia after Allogeneic BMT
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김동욱
진종률/이종욱/한치화/민우성/박종원/김춘추/김원일/김동집
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Abstract
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Background:
@EN Patients who relapse after allogeneic BMT for leukemia have little prospect of prolonged survival due to drug induced resistance & increasing complications.
Recently, induction of GVL effect by IFN and the infusion of leucocytes from the original boen marrow donor has been used with some success in patients with leukemia who have relapsed after BMT.
In this study, we describe the effect of Interferon and/or the infusion of donor peripheral blood leucocytes in leukemia (CML-6/AML-2 cases) relapsing after allogeneic BMT.
@ES Methods:
@EN All patients were treated with alpha 2a or gamma recombinant interferon (Lucky Co., Korea) starting with a dose of 3×10E6iu/㎡, subcutaneously, daily and increasing to 5×10E6㎡ according to hematological tolerance and subsequently the
therapy
was
administered three times a week.
Four of the patients (CML-2/AML-2 cases) were treated with donor buffy coat.
Leucocytes, freshly obtained from the original bone marrow donor were infused daily or every other day for three times. No prophylactic immunosuppression was used.
Microscopic examinations and cytogenetic studies were carried out monthly on marrow samples.
Molecular studies for bcr/abl fusion gene using RT-PCR were performed on RNA obtained from bone marrow of CML patients.
@ES Results:
@EN 1) Among the initial 8 patients, six patients have had a complete disappearance of leukemic blasts and 2 patients had no significant response.
2) Elapsed time to remission was 80 days in median (range: 20-150 days).
3) In the six patients with remission, all developed graft versus host disease and 2 of three CML patients with molecular remission were alive for 37 months and 11 momths respectively.
4) Causes of death in patients with remission were severe GvHD (2 cases), marrow failure (1 case) and leukemia relapse (1 case) after 5 months.
@ES Conclusion:
@EN Interferon and/or donor buffy coat infusion may produce durable remissions in patients with leukemia relapsing after BMT and that this may be due to a graft versus leukemia effects, but the precautions to complications resulting from
immunomodulatory therapy are needed.
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KEYWORD
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