T and B lineage ALL cells express different levels of HLA-class II antigens, which may serve as targets for graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL). The object of this study was to determine whether GVL effects after HLA-identical sibling bone marrow transplantation differed in T and B lineage ALL. We studied 1132 patients with ALL of T lineage (n = 416) or of B lineage (cALLa+) (n = 716) transplanted in first (n = 605) or second (n = 527) remission with bone marrow from an HLA-identical sibling donor, between 1982 and 1992, and reported to the IBMTR by 165 teams. Cox proportional hazards regression models were used to determine the relative risk (RR) of relapse in patients with acute (grades II-IV) or chronic GVHD vs patients without GVHD. Acute and chronic GVHD were considered as time-dependent covariates. Patients transplanted in first and second remission were analyzed separately. GVHD decreased relapse risks to a similar extent in T and B lineage ALL. For first remission transplants, relative risks of relapse for patients with vs those without GVHD was 0.34 for T lineage ALL and 0.44 for B lineage ALL. Corresponding relative risks in second remission transplants were 0.54 and 0.61. This study confirms earlier findings of an antileukemia effect of GVHD in ALL. This effect was similar in T lineage and B lineage ALL, despite probable differences in HLA-class II antigen expression.
Bibliographical noteFunding Information:
This work was supported by Public Health Service Grant PO1-CA-40053 from the National Cancer Institute, the National Institute of Allergy and Infectious Diseases, and the National Heart, Lung and Blood Institute of the US Department of Health and Human Services; and grants from Alpha Therapeutic Corporation; Amgen, Inc.; Astra Pharmaceutical; Basel Cancer League, Switzerland; Baxter Healthcare Corporation; Bayer Corporation; Biogen; Blue Cross and Blue Shield Association; Lynde and Harry Bradley Foundation; Bristol-Myers Squibb Company; Frank G Brotz Family Foundation; Cancer Center, Medical College of Wisconsin; CellPro, Inc.; Centeon; Center for Advanced Studies in Leukemia; Charles E Culpeper Foundation; Ciba-Geigy Jubi-laeums Foundation, Switzerland; Eleanor Naylor Dana Charitable Trust; Eppley Foundation for Research; Free Academic Society, Basel, Switzerland; Genentech, Inc.; Glaxo Wellcome Company; Hoechst Marion Roussel, Inc.; Immunex Corporation; Janssen Pharmaceutica; Kettering Family Foundation; Kirin Brewery Company; Robert J Kleberg, Jr and Helen C Kleberg Foundation; Herbert H Kohl Charities, Inc.; Eli Lilly Company Foundation; Nada and Herbert P Mahler Charities; Milstein Family Foundation; Milwaukee Foundation/Elsa Schoeneich Research Fund; Samuel Roberts Noble Foundation; Ortho Biotech Corporation; John Oster Family Foundation; Elsa U Pardee Foundation; Jane and Lloyd Pettit Foundation; Alirio Pfiffer Bone Marrow Transplant Support Association; Pfizer, Inc.; Pharmacia and Upjohn; RGK Foundation; Sandoz Pharmaceuticals; Schering-Plough International; Walter Schroeder Foundation; Searle; Stackner Family Foundation; Starr Foundation; Joan and Jack Stein Charities; Swiss National Science Foundation; and Wyeth-Ayerst Laboratories.
- B lineage
- Bone marrow transplantation
- T lineage