Kw. Vanbesien et al., MANAGEMENT OF LYMPHOMA RECURRENCE AFTER ALLOGENEIC TRANSPLANTATION - THE RELEVANCE OF GRAFT-VERSUS-LYMPHOMA EFFECT, Bone marrow transplantation, 19(10), 1997, pp. 977-982
Donor lymphocyte infusions, by virtue of a graft-versus-tumor effect,
have been shown to induce remissions in leukemia that recurs after all
ogeneic bone marrow transplantation. Similar effects have been postula
ted to contribute to the decreased recurrence rate observed after allo
geneic transplantation in non-Hodgkin's lymphoma. This lower recurrenc
e rate may be due to a variety of other mechanisms. We aimed to evalua
te the role of graft-versus-lymphoma effects in patients in whom lymph
omas recur after allogeneic transplantation. At the time of recurrence
, immunosuppressive therapy was withheld. Patients with non-responding
disease received an infusion of donor lymphocytes, Patients were obse
rved for response and graft-versus-host disease. Disease in four of ni
ne patients responded to withdrawal of immunosuppressive therapy, A mi
nor response was observed in one of three recipients of donor lymphocy
te infusions, Responses were observed among two patients with follicul
ar lymphoma, one with large cell lymphoma and one with lymphoblastic l
ymphoma, A minor response was observed in a patient with prolymphocyti
c leukemia/lymphoma. We conclude that withdrawal of immunosuppressive
therapy and donor lymphocyte infusion can induce durable remissions in
patients with recurrent lymphoma after allogeneic transplantation.