[The Success of Lymphocyte Infusion As Treatment of Leukemia Recurrence Following Allogeneic Bone Marrow Transplantation Depends on Low Percentage of Patient's Own Lymphocytes]

Objective: Evaluation of induction of complete remission with infusion of lymphocytes from the original bone marrow donor in patients with leukaemia which relapsed after allogeneic bone marrow transplantation.

Setting: Division of Haematology, University Hospital Nijmegen and the Red Cross Blood Bank Nijmegen, the Netherlands.

Design: Prospective, non-randomized study.

Methods: Twenty-eight patients who relapsed after allogeneic bone marrow transplantation were treated with infusion of lymphocytes from the original bone marrow donor. Lymphocytes were collected by means of leukapheresis. Follow-up was done by frequent checks at the outpatient clinic.

Results: Eleven of 15 (73%) patients with relapsed chronic myeloid leukaemia (CML) and only one of 13 patients (8%) with a relapse of acute leukaemia went into complete remission (p < 0.001). Entering complete remission was always preceded by acute or chronic graft-versus-host disease (GVHD). The development of acute and/or chronic GVHD was significantly associated with the origin of T-lymphocytes in the blood of the recipient at the time of infusion. If the T-lymphocytes came mostly from the patient himself, the infusion remained usually without effect. If the T-lymphocytes came mostly from the donor, the patients went into complete remission.

Conclusion: Patients with a relapse of leukaemia after allogeneic bone marrow transplantation may enter complete remission after infusion of lymphocytes from the original marrow donor. This form of immunotherapy can be successful especially in patients with a relapsed CML with a relatively low percentage of autologous T-lymphocytes at the time of infusion.