Chemotherapy in refractory Rer CLL, with a progression by regulating production, it can not determine m Possible, whether it is likely GVT activity of t, and is a very difficult challenge treatment. If a plan is available warned it w re Sense, BX-912 an attempt to mobilize support for the view DLI. Tenacious in the case of Storeyed LLC in the establishment of full donor Chim Terrorism, may be present in clinical GVT. Without the Erh Increase w It re useful to consider watchful waiting, dam Ftigen the withdrawal of immunosuppression and / or DLI if no response is observed after the revival, with the addition of rituximab, if there is evidence indolent progression. Erh hung Of the LLC for the treatment of GVHD, GVT reaction may be suspected blunt .
. There is no established treatment Sans Courts, allowing the GVT in this context and the goals of treatment should be monitored L tumor with minimal additionally Tzlicher toxicity t. Reasonable alternatives Nutlin-3 include local radiotherapy, rituximab monotherapy, and a function Dependence of the locations of the disease. Intense security, Vis Vis à GVHD and graft function has not been established, and there are data that suggest the long-term effectiveness. Alemtuzumab-containing salvage therapy may au OUTSIDE recommended a clinical trial, since the risk of potentially irreversible immune-al Porter et al. Page 29 of Biol Blood Marrow Transplant. Author manuscript, increases available in PMC 2011 1 November. Suppression, particularly in connection with the active GVHD and disadvantages indication for DLI.
Evaluation of experimental therapies should always be considered. Sp Trezidiven assessment should determine an assessment of the bone marrow and peripheral blood Chim Tourism a comprehensive assessment of the stage to see the sights of the disease, and biopsy to determine the active disease on histology and / or Chim Terrorism, c. processing to refuse the post-transplant lymphoproliferative disease, CLL donors. , The end of lymph node recurrence in the absence of bone marrow involvement, the transformation of the tumor more aggressive to reflect: The following considerations affect specific treatment strategies. The goals of treatment should be monitored L stimulate the tumor and allograft function, and the inclusion of a very active salvage therapy with stem cells to mobilize the support of the DLI is feasible.
Recurrence of CLL may reflect the waning power of POTA are m Possible causes CLL immune escape, with the outgrowth of resistant clones allo and / or burn out the reaction of the immune donors. Treatment goals are to improve the sensitivity of the disease and / or restore the power of GVT effects. In an indolent relapse, w It re reasonable, a study withdrawal of immunosuppression, when considered m Possible, followed by DLI with or without rituximab. And consider more aggressive recurrence, w Re it acceptable, the use of salvage chemotherapy with DLI, even if the patient is refractory in the past. The recurrent CLL may have lost power, and lympho-depleting effect The dosage can to support the subsequent recovery of GVT.
Very sp T recurrence of the LLC and / or at the end of the cable should again be prompted consideration of a donor of CLL, particularly at receiver Ngern of allogeneic donor brothers with a family history of malignant lymphocytes Of. given the growing prevalence of MBL with the age of 50 years, even in the absence of family history, bone marrow sp th relapse in patients whose donor was over 50 years could represent a CLL transferred. It w Re