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Outcome of patients developing GVHD after DLI given to treat CML relapse: a study by the chronic leukemia working party of the EBMT

Chalandon, Y.; Passweg, J. R.; Schmid, C.; Olavarria, E.; Dazzi, F.; Simula, M. P.; Ljungman, P.; Schattenberg, A.; de Witte, T. and Lenhoff, Stig LU , et al. (2010) In Bone Marrow Transplantation 45(3). p.558-564
Abstract
We studied GVHD after donor lymphocyte infusion (DLI) in 328 patients with relapsed CML between 1991 and 2004. A total of 122 patients (38%) developed some form of GVHD. We analyzed GVHD by clinical presentation (acute or chronic GVHD) and onset time after the first DLI (early (<= 45 days) or late (>45 days)). There was a significant overlap between onset time and clinical presentation. Some form of GVHD occurred at a median of 104 days, acute GVHD at 45 days and chronic GVHD at 181 days after DLI. The clinical presentation was acute GVHD in 71 patients, of whom 31 subsequently developed chronic GVHD subsequently. De novo chronic GVHD was seen in 51 patients. OS for all patients was 69% (95% confidence interval (CI) 63-75) at 5... (More)
We studied GVHD after donor lymphocyte infusion (DLI) in 328 patients with relapsed CML between 1991 and 2004. A total of 122 patients (38%) developed some form of GVHD. We analyzed GVHD by clinical presentation (acute or chronic GVHD) and onset time after the first DLI (early (<= 45 days) or late (>45 days)). There was a significant overlap between onset time and clinical presentation. Some form of GVHD occurred at a median of 104 days, acute GVHD at 45 days and chronic GVHD at 181 days after DLI. The clinical presentation was acute GVHD in 71 patients, of whom 31 subsequently developed chronic GVHD subsequently. De novo chronic GVHD was seen in 51 patients. OS for all patients was 69% (95% confidence interval (CI) 63-75) at 5 years, DLI-related mortality was 11% (95% CI 8-15) and disease-related mortality was 20% (95% CI 16-25). Risk factors for developing GVHD after DLI were T-cell dose at first DLI, the time interval from transplant to DLI and donor type. In time-dependent multivariate analysis, GVHD after DLI was associated with a risk of death of 2.3-fold compared with patients without GVHD. Clinical presentation as acute GVHD and early onset GVHD were associated with increased mortality. (Less)
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Contribution to journal
publication status
published
subject
keywords
allo-SCT, GVHD, CML, DLI, relapse
in
Bone Marrow Transplantation
volume
45
issue
3
pages
558 - 564
publisher
Nature Publishing Group
external identifiers
  • wos:000275360700021
  • scopus:77949423074
ISSN
1476-5365
DOI
10.1038/bmt.2009.177
language
English
LU publication?
yes
id
ffe21406-c27e-42dc-9810-fa6aa7c64d15 (old id 1589153)
date added to LUP
2010-04-20 14:05:36
date last changed
2018-05-29 10:38:17
@article{ffe21406-c27e-42dc-9810-fa6aa7c64d15,
  abstract     = {We studied GVHD after donor lymphocyte infusion (DLI) in 328 patients with relapsed CML between 1991 and 2004. A total of 122 patients (38%) developed some form of GVHD. We analyzed GVHD by clinical presentation (acute or chronic GVHD) and onset time after the first DLI (early (&lt;= 45 days) or late (&gt;45 days)). There was a significant overlap between onset time and clinical presentation. Some form of GVHD occurred at a median of 104 days, acute GVHD at 45 days and chronic GVHD at 181 days after DLI. The clinical presentation was acute GVHD in 71 patients, of whom 31 subsequently developed chronic GVHD subsequently. De novo chronic GVHD was seen in 51 patients. OS for all patients was 69% (95% confidence interval (CI) 63-75) at 5 years, DLI-related mortality was 11% (95% CI 8-15) and disease-related mortality was 20% (95% CI 16-25). Risk factors for developing GVHD after DLI were T-cell dose at first DLI, the time interval from transplant to DLI and donor type. In time-dependent multivariate analysis, GVHD after DLI was associated with a risk of death of 2.3-fold compared with patients without GVHD. Clinical presentation as acute GVHD and early onset GVHD were associated with increased mortality.},
  author       = {Chalandon, Y. and Passweg, J. R. and Schmid, C. and Olavarria, E. and Dazzi, F. and Simula, M. P. and Ljungman, P. and Schattenberg, A. and de Witte, T. and Lenhoff, Stig and Jacobs, P. and Volin, L. and Iacobelli, S. and Finke, J. and Niederwieser, D. and Guglielmi, C.},
  issn         = {1476-5365},
  keyword      = {allo-SCT,GVHD,CML,DLI,relapse},
  language     = {eng},
  number       = {3},
  pages        = {558--564},
  publisher    = {Nature Publishing Group},
  series       = {Bone Marrow Transplantation},
  title        = {Outcome of patients developing GVHD after DLI given to treat CML relapse: a study by the chronic leukemia working party of the EBMT},
  url          = {http://dx.doi.org/10.1038/bmt.2009.177},
  volume       = {45},
  year         = {2010},
}