Page 325 - Essential Haematology

Chapter 23 Stem cell transplantation / 311

Detection of
Philadelphia
chromosome
by cytogenetics
PCR for
BCR-ABL1
DLI
+
7
10 CD3 /kg
10
WBC (x 10 9 /L) 5

0
-2 0 3 6 9 12 15 18 21 24
Months post-SCT
SCT

Figure 23.11 Donor leucocyte infusions. Example of donor leucocyte infusion (DLI) in the treatment of chronic

myeloid leukaemia (CML) which relapsed following allogeneic stem cell transplantation (SCT). Polymerase chain
reaction (PCR) analysis of the blood for the BCR - ABL1 transcript shows that there was transient loss of the
transcript but molecular and cytogenetic relapse occurred at 10 months. One infusion of donor leucocytes led to
re - establishment of a durable complete remission.

(b)

(a) (b)

Figure 23.12 Example of disease control following administration of a donor leucocyte infusion (DLI) after stem

cell transplantation. (a) A PET scan revealed residual disease activity in a patient at 6 months following
allogeneic transplantation for non - Hodgkin lymphoma. The bright signals refl ect the metabolic activity of
malignant cells in the spleen and axillary lymph nodes. Donor leucocyte infusion was then given and after 3
months a repeat PET scan (b) revealed no evidence of residual disease. (Image with kind permission of
Professor Nigel Russell.)