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51. Bone Marrow Transplantation

Historical

Thomas, E. D., Lochte, H. L., Jr., Lu, W. C. and Ferrebee, J. W.
(1957). Intravenous infusion of bone marrow in patients receiving radiation and chemotherapy.
N Engl J Med 257(11): 491-6..
Description: A first report of a (transiently) successful graft in humans.
PubMed citation number: 13464965
Thomas, E. D., Lochte, H. L., Jr., Cannon, J. H., Sahler, O. D. and Ferrebee, J. W.
(1959). Supralethal whole body irradiation and isologous marrow transplantation in man. J Clin Invest 38: 1709-16.
Description: The first report of a syngeneic bone marrow transplant for pediatric ALL. It showed successful engraftment but early relapse - discussion includes speculation about the potential need for a graft versus leukemia effect.
PubMed citation number: 13837954.

GVHD and GVL

Weiden, P. L., Flournoy, N., Thomas, E. D., Prentice, R., Fefer, A., Buckner, C. D. and Storb, R.
(1979). Antileukemic effect of graft-versus host disease in human recipients of allogeneic-marrow grafts.
N Engl J Med 300(19): 1068-73..
Description: The paper that showed that allogeneic transplant has a lower relapse rate than syngeneic transplant, and that patients who have GVHD have a lower risk of relapse, although there was no improvement in survival for those patients with GVHD. Contrary to current thinking, the antileukemic effect appeared stronger against ALL than myeloid malignancies
PubMed citation number: 34792.
Weiden, P. L., Sullivan, K. M., Flournoy, N., Storb, R. and Thomas, E. D.
(1981). Antileukemic effect of chronic graft versus-host disease: contribution to improved survival after allogeneic marrow transplantation.
N Engl J Med 304(25): 1529-33.
Chronic GVHD also confers antileukemic activity.
PubMed citation number: 7015133.
Horowitz, M. M., R. P. Gale, et al.
(1990) .Graft-versus-leukemia reactions after bone marrow transplantation.
Blood 75(3): 555-62.
Description: A large retrospective study (2,254 people) of recipients of HLA-identical sibling transplants (allogeneic and syngeneic) for AML, ALL, and CML, comparing relapse in patients receiving T-cell depleted marrow or non-TCD marrow, and comparing relapse in patients with or without GVHD. The data supports:
•  An antileukemic effect of GVHD.
•  An antileukemic effect of allografts independent of GVHD.
PubMed citation number: 2297567.
Porter, D. L., Roth, M. S., McGarigle, C., Ferrara, J. L. and Antin, J. H.
(1994). Induction of graft-versus-host disease as immunotherapy for relapsed chronic myeloid leukemia.
N Engl J Med 330(2): 100-6.
Description: An early paper establishing the antileukemic activity of DLI in relapsed chronic phase CML post transplant.
PubMed citation number: 8259165.

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