T cell and NK cell mediated graft-versus-leukaemia reactivity following donor buffy coat transfusion to treat relapse after marrow transplantation for chronic myeloid leukaemia

Bone Marrow Transplant. 1993 Feb;11(2):133-8.

Abstract

Two patients with chronic myeloid leukaemia in cytogenetic relapse following T lymphocyte-depleted BMT were treated with transfusions of donor buffy coat leucocytes. In both patients the marrow reverted to a completely normal karyotype and was negative for the BCR-ABL fusion gene transcript by polymerase chain reaction analysis. Before buffy coat transfusion the cytotoxic T lymphocyte precursor frequency against pre-BMT patient leukaemia cells (Lk-CTLP) was lower than that against pre-BMT patient PHA-transformed lymphocytes (Ly-CTLP) in both cases. At 2 weeks (case 1) and 8 weeks (case 2) after transfusion this ratio inverted so that Lk-CTLP predominated. Natural killer (NK) function fell initially and then recovered to exceed pre-transfusion values prior to normalization of the bone marrow karyotype. These changes in cytotoxic T lymphocytes and NK cells following donor buffy coat transfusions for patients with relapsed chronic myeloid leukaemia after marrow transplantation support the concept of a graft-versus-leukaemia effect mediated by both MHC restricted and non-restricted pathways.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Component Transfusion*
  • Bone Marrow Transplantation*
  • Combined Modality Therapy
  • Female
  • Fusion Proteins, bcr-abl / genetics
  • Genetic Markers
  • Graft vs Host Reaction*
  • Humans
  • Killer Cells, Natural / immunology*
  • Killer Cells, Natural / transplantation
  • Leukemia, Myeloid, Accelerated Phase / surgery
  • Leukemia, Myeloid, Accelerated Phase / therapy*
  • Leukemia, Myeloid, Chronic-Phase / surgery
  • Leukemia, Myeloid, Chronic-Phase / therapy*
  • Lymphocyte Depletion
  • Male
  • Polymerase Chain Reaction
  • RNA, Messenger / analysis
  • Salvage Therapy
  • T-Lymphocyte Subsets / immunology*
  • T-Lymphocyte Subsets / transplantation

Substances

  • Genetic Markers
  • RNA, Messenger
  • Fusion Proteins, bcr-abl