GRAFT-VERSUS-HOST DISEASE FOLLOWING INTERLEUKIN-2 LYMPHOKINE-ACTIVATED KILLER (LAK) CELL IMMUNOTHERAPY IN A PATIENT WITH ACUTE MYELOGENOUS LEUKEMIA IN 2ND COMPLETE REMISSION - AUTOLOGOUS LAK CELLS FOLLOWING ALLOGENEIC BONE-MARROW TRANSPLANTATION ARE DONOR-DERIVED

A 48-year-old man was treated by allogeneic bone marrow transplantatio n (BMT) in first remission of M4 acute myelogenous leukaemia (AML). He experienced no raft-versus-host disease (GVHD) and 7 months later he relapsed. Following further chemotherapy he entered a second complete remission: however, he refused a further allogeneic or autologous BMT but agreed to immunotherapy with interleukin-2 and autologous lymphoki ne-activated killer (LAK) cells. He tolerated this treatment well but went on to develop grade II skin GVHD. Polymerase chain reaction studi es of DNA microsatellites of the autologous LAK cells showed that they were of donor origin. The patient remained well for 9 months until, i mmediately follow in the introduction of prednisolone for his persiste nt GVHD he relapsed. He declined further active treatment and died 5 m onths later. The case shows that IL-2/LAK cells can be safely given to patients who have experienced no GVHD following allo-BMT and are like ly to be effective through an ongoing graft-versus-leukaemia effect.