Modified Donor Lymphocyte Infusion (DLI) for the Prophylaxis of Leukemia Relapse after Hematopoietic Stem Cell Transplantation in Patients with Advanced Leukemia—Feasibility and Safety Study
We retrospectively evaluated the feasibility and safety of a modified prophylactic donor lymphocytes infusion (DLI) approach in advanced leukemia.
Materials and methods
Thirty-three patients with advanced leukemia received modified prophylactic DLI; that is, granulocyte colony-stimulating factor-primed peripheral blood progenitor cells instead of steady-donor lymphocyte harvests were used, and a short-term immunosuppressive agent (cyclosporine A or methotrexate 10 mg once per week for 2 to 4 weeks) was used for prevention of DLI-associated graft versus host disease (GVHD) after human leukocyte antigen-identical sibling hematopoietic stem cell transplantation.
Thirty-nine infusions were performed in 33 patients. The mononuclear cells and median CD3+ cells infused for DLI were 1–2 × 108 and 0.93 × 106 per kilogram, respectively. Six patients experienced II–IV-grade acute GVHD. Twenty patients developed chronic GVHD. No GVHD-related death or transfusion-related pancytopenia was observed. With an 18-month median follow-up, 16 patients were in disease-free survival, and overall survival at 1 and 1.5 years was 69.0% and 50.2%, respectively.
The modified prophylactic DLI strategy might represent a step forward in the treatment of advanced leukemia.
KeywordsAdvanced leukemia donor lymphocytes infusion granulocyte colony-stimulating factor hematopoietic stem cell transplantation
This article is supported in part from Hi-tech Research and Development Program of China, Innovation Team Program of Ministry of Education of China, National Outstanding Young Talent Natural Science Foundation, Leading Program of Clinical Faculty accredited by the Ministry of Health of China.
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