Treatment of relapsed blast-phase Philadelphia-chromosome-positive leukaemia after non-myeloablative stem-cell transplantation with donor lymphocytes and imatinib

Leukaemia relapse remains a major cause of treatment failure after allogeneic haemopoietic-cell transplantation for patients with advanced-phase chronic myelogenous leukaemia or Philadelphia-chromosome-positive acute lymphoblastic leukaemia. By contrast with cytogenetic or haematological relapse, patients who relapse with blast-phase chronic myelogenous leukaemia or Philadelphia-chromosome-positive acute lymphoblastic leukaemia have a low probability of responding to donor-lymphocyte infusions 1 Collins Jr, RH Shpilberg O Drobyski WR et al. Donor leukocyte infusions in 140 patients with relapsed malignancy after allogeneic bone-marrow transplantation. J Clin Oncol. 1997; 15: 433-444 Crossref PubMed Scopus (1114) Google Scholar , 2 Alyea EP Soiffer RJ Canning C et al. Toxicity and efficacy of defined doses of CD4(+) donor lymphocytes for treatment of relapse after allogeneic bone marrow transplant. Blood. 1998; 91: 3671-3680 Crossref PubMed Google Scholar or imatinib when given alone. 3 Olavarria E Ottmann OG Deininger M et al. Response to imatinib in patients who relapse after allogeneic stem cell transplantation for chronic myeloid leukemia. Leukemia. 2003; 17: 1707-1712 Crossref PubMed Scopus (101) Google Scholar , 4 Shimoni A Kroger N Zander AR et al. Imatinib mesylate (STI571) in preparation for allogeneic hematopoietic stem cell transplantation and donor lymphocyte infusions in patients with Philadelphia-positive acute leukemias. Leukemia. 2003; 17: 290-297 Crossref PubMed Scopus (79) Google Scholar Here, we report a favourable outcome in two patients treated at our institution who were given imatinib combined with donor-lymphocyte infusions as salvage treatment for relapse in advanced-phase Philadelphia-chromosome-positive leukaemia after non-myeloablative allogeneic haemopoietic-cell transplantation.