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Plasma Cell Disorders

Donor T-cell responses and disease progression patterns of multiple myeloma

Bone Marrow Transplantation volume 52, pages 1609–1615 (2017)Cite this article

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Abstract

Donor T-cells transferred after allogeneic stem cell transplantation (alloSCT) can result in long-term disease control in myeloma by the graft-versus-myeloma (GvM) effect. However, T-cell therapy may show differential effectiveness against bone marrow (BM) infiltration and focal myeloma lesions resulting in different control and progression patterns. Outcomes of 43 myeloma patients who underwent T-cell-depleted alloSCT with scheduled donor lymphocyte infusion (DLI) were analyzed with respect to diffuse BM infiltration and focal progression. For comparison, 12 patients for whom a donor search was started but no alloSCT was performed, were analyzed. After DLI, complete disappearance of myeloma cells in BM occurred in 86% of evaluable patients. The probabilities of BM progression-free survival (PFS) at 2 years after start of donor search, alloSCT and DLI, were 17% (95% confidence interval 0–38%), 51% (36–66%), and 62% (44–80%) respectively. In contrast, the probabilities of focal PFS at 2 years after start of donor search, alloSCT and DLI, were 17% (0–38%), 30% (17–44%) and 28% (11–44%), respectively. Donor-derived T-cell responses effectively reduce BM infiltration, but not focal progression in myeloma, illustrating potent immunological responses in BM with only limited effect of T-cells on focal lesions.

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Acknowledgements

This work was supported by research grant 2008-4263 from the Dutch Cancer Society, Amsterdam, The Netherlands. We thank Illyea Hawke (DKMS, Germany) for correcting the language of the manuscript.

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Author notes

  1. M Eefting and L C de Wreede: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands

    M Eefting, P A Von dem Borne, C J M Halkes, S Kersting, E W A Marijt, H Veelken & J H F Falkenburg

  2. Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands

    L C de Wreede & H Putter

  3. Medical Department I, University Hospital Carl Gustav Carus, Technische Universität Dresden & DKMS, German Bone Marrow Donor Center, Dresden, Germany

    J Schetelig

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  1. M Eefting
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Correspondence to L C de Wreede.

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Eefting, M., de Wreede, L., Von dem Borne, P. et al. Donor T-cell responses and disease progression patterns of multiple myeloma. Bone Marrow Transplant 52, 1609–1615 (2017). https://doi.org/10.1038/bmt.2017.201

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