Molecular remission of CML after autotransplantation followed by adoptive transfer of costimulated autologous T cells

A. P. Rapoport, B. L. Levine, A. Badros, B. Meisenberg, K. Ruehle, A. Nandi, S. Rollins, S. Natt, B. Ratterree, S. Westphal, D. Mann, C. H. June

Research output: Contribution to journalArticlepeer-review

Abstract

Four patients with chronic myelogenous leukemia (CML) that was refractory to interferon alpha (two patients) or imatinib mesylate (two patients), and who lacked donors for allogeneic stem cell transplantation, received autotransplants followed by infusions of ex vivo costimulated autologous T cells. At day +30 (about 14 days after T-cell infusion), the mean CD4+ cell count was 481 cells/μl (range 270-834) and the mean CD8+ count was 516 cells/μl (range 173-1261). One patient had a relative lymphocytosis at 3.5 months after T-cell infusion, with CD4 and CD8 levels of 750 and 1985 cells/μl, respectively. All the four patients had complete cytogenetic remissions early after transplantation, three of whom also became PCR negative for the bcr/abl fusion mRNA. One patient, who had experienced progressive CML while on interferon alpha therapy, became PCR- post transplant, and remained in a molecular CR at 3.0 years of follow-up. All the four patients survived at 6, 9, 40, and 44 months post transplant; the patient who remained PCR+ had a cytogenetic and hematologic relapse of CML, but entered a molecular remission on imatinib. Autotransplantation followed by costimulated autologous T cells is feasible for patients with chronic phase CML, who lack allogeneic donors and can be associated with molecular remissions.

Original languageEnglish (US)
Pages (from-to)53-60
Number of pages8
JournalBone marrow transplantation
Volume33
Issue number1
DOIs
StatePublished - Jan 2004

Keywords

  • Autotransplantation
  • CML
  • Chronic myelogenous leukemia
  • Costimulation
  • Imatinib mesylate
  • T-cell immunotherapy

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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