ALLOGENEIC CELL-MEDIATED AND CYTOKINE-ACTIVATED IMMUNOTHERAPY FOR MALIGNANT-LYMPHOMA AT THE STAGE OF MINIMAL RESIDUAL DISEASE AFTER AUTOLOGOUS STEM-CELL TRANSPLANTATION

Immunocompetent donor-derived T lymphocytes play a crucial role in the elimination of residual leukemic cells post allogeneic bone marrow tr ansplantation. Because this graft versus leukemia (GVL) effect is abse nt after autologous stem cell transplantation (ASCT), a high rate of r elapse ensues. We introduced cell-mediated immunotherapy at the stage of minimal residual disease in lymphoma patients to help effect a GVL- like reaction by adoptive transfer of immunocompetent human leukocyte antigen-matched donor peripheral blood lymphocytes (PBL). Thirteen con secutive patients with high-risk lymphoma were treated with allogeneic cell therapy (AlloCT) after having undergone ASCT. In the absence of graft-versus-host disease, cell thera py-induced graft-versus-lymphoma reaction was amplified by human recombinant interleukin 2 (rIL-2) dur ing 3 days to activate donor PBL in vivo, followed by infusion of in v itro rIL-2 activated donor lymphocytes combined with 3-day rIL-2 thera py. Nine of the patients underwent the treatment protocol well. In the four other patients, in whom the AlloCT resulted in marrow aplasia du e to elimination of host hematopoietic cells, treatment with donor mar row cell infusion without further conditioning was performed. Adoptive cell therapy in the form of AlloCT may turn out to be an effective th erapeutic modality for the treatment of resistant residual disease in lymphoma patients.