Donor lymphocyte infusion for a patient with relapsing myelodysplastic syndrome after allogeneic bone marrow transplantation [letter]

Bressoud, Albéric; Chapuis, B; Roux, Étienne; Cabrol, C; Jeannet, M; Roosnek, Eddy; Helg, Claudine

doi:10.1182/blood.v88.5.1902.1902

Cited by 8 publications

(2 citation statements)

References 7 publications

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“…This has not been systematically studied [81]. On the other hand, there are several reports of successful donor buffy coat infusions for relapse after allogeneic BMT for MDS [90][91][92], and this graft-versus-leukemia effect may be exploited with peripheral blood allogeneic BMT as opposed to marrow-derived BMT [93].…”

Section: The High-risk or Intermediate-2 Ipss Groupmentioning

confidence: 99%

Understanding the Myelodysplastic Syndromes

Kouides

Bennett

1997

The Oncologist

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The myelodysplastic syndrome (MDS) remains challenging to the clinician in terms of diagnosis and management. The diagnosis is essentially one of exclusion in first ruling out other disorders that can also cause peripheral blood/bone marrow cell dysplasia and cytopenias. The distinguishing biological characteristic of MDS is that it is a clonal disorder of the marrow with impaired differentiation. Recent studies implicate extensive apoptosis as the explanation of the paradoxical observation of marrow hyperplasia but peripheral blood cytopenia. Neutropenia and/or neutrophil dysfunction account for the primary clinical manifestation of MDS in terms of an increased risk for infection, which is the leading cause of death in MDS. The clonal nature of MDS places it also at continual risk for transformation to acute leukemia. Predicting overall survival as well as the risk of AML transformation has been improved by the recent development of a scoring system (International Prognostic Scoring System) that incorporates three laboratory variables: percent of marrow blasts, degree of cytopenias, and presence of chromosomal abnormalities. Based on these variables, four prognostic subgroups can be delineated ranging from low risk with a median survival of 5.7 years, to high risk with a median survival of 0.4 years. Management of MDS can now be based on the patient's respective prognostic subgrouping, with low‐risk patients being considered for hematopoietic growth factor singly or in combination if at the point of red cell transfusion dependence and/or neutropenia with recurrent infections, while high‐risk patients should be offered AML‐induction therapy or novel agents such as Topotecan. One must individualize further in patients in the remaining intermediate groups, I and II, in choosing the most appropriate therapy. Future advances upon understanding the molecular details of the MDS clone should ultimately improve the care of patients with MDS.

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Section: The High-risk or Intermediate-2 Ipss Groupmentioning

confidence: 99%

Understanding the Myelodysplastic Syndromes

Kouides

Bennett

1997

The Oncologist

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“…The demonstration of this GVL effect and of the primordial role of T‐lymphocytes led investigators to transfuse donor lymphocytes to CML patients relapsing after HPC transplantation 8–14 . Indeed, donor lymphocyte infusions (DLIs) have increasingly been used to treat relapse after HPC transplantation not only for CML but also for acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), myelodysplastic syndrome (MDS), multiple myeloma (MM), and non‐Hodgkin's lymphoma 15–22 …”

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confidence: 99%