Induction Of GvM After Myeloablative Transplant

Improvement in outcome of myeloablative allogeneic transplantation requires reducing TRM and maximizing the GvM effect. One strategy involves combining a myeloablative T-cell-depleted transplantation with DLI in hopes of reducing the TRM associated with the transplant procedure while augmenting the GvM effect. Twenty-four patients at DFCI were enrolled in a trial combining a T-cell-depleted myeloablative transplant with prophylactic DLI, 6 months after transplan-tation.53 Twenty-one patients received cyclophosphamide and TBI ablative therapy; busulfan and cylophosphamide were used in those three patients in whom prior radiation precluded TBI. The bone marrow was purged of T cells with anti-CD6 monoclonal antibody as the sole means of GvHD prophylaxis. Despite the use of T-cell depletion, just over half of the 24 patients were eligible to receive DLI. Reasons for not receiving DLI included rapid relapse, transplant-related complications such as interstitial pneumonitis, and GvHD. Nine of the 11 patients who were eligible to receive DLI at 6 months demonstrated a response,

Table 85.2 Results of Patients with Multiple Myeloma treated with DLI

Studies_N_Prior chemotherapy_CR (%)_PR (%)_Overall RR (%)

References

0 0

Post a comment