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A retrospective single-center analysis of G-CSF-mobilized donor lymphocyte infusion in hematologic malignancies after unmanipulated allogenic PBSCT

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Abstract

To explore the efficacy and safety of G-SCF-mobilized donor lymphocyte infusion (DLI) for treatment of relapse of hematologic malignancies after allogeneic peripheral blood stem cell transplantation, we performed a retrospective analysis in a cohort of patients with morphologic (n = 36) or molecular (n = 22) relapse post transplantation. The 3-year post-DLI survival rates for therapeutic and preemptive DLI recipients were 16.7% and 33.3%, respectively. The occurrence of DLI-associated acute graft-versus-host disease predicted longer survival, whereas diagnosis of T cell acute lymphoblastic leukemia/lymphoma or myelodysplastic syndromes or early relapse after transplant (< 6 months) predicted shorter survival after therapeutic DLI. Cumulative incidence of progression to hematologic relapse and non-relapse mortality after preemptive DLI were 46.8% and 29.1%, respectively. Active disease prior to transplant and early molecular relapse after transplant (< 4 months) were the strongest predictors of non-relapse mortality after preemptive DLI. In conclusion, although therapeutic DLI had limited efficacy against T cell acute lymphoblastic leukemia/lymphoma or myelodysplastic syndromes or early post-transplant relapse, patients who developed DLI-associated acute graft-versus-host disease would benefit from this procedure in the setting of G-SCF-mobilized DLI. Furthermore, preemptive DLI could protect half of patients from hematologic relapse after transplantation with acceptable toxicity.

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Acknowledgements

This work was partially supported by grants from the National Natural Science Foundation of China (81870109 and 82070149 to X-N G) and Natural Science Foundation of Beijing Municipality (7202191 to X-N G).

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Author notes

  1. Ning Lu, Ji Lin, Li-Li Wang these authors contributed equally to this work.

Authors and Affiliations

  1. Senior Department of Hematology, The Fifth Medical Center, Chinese PLA General Hospital, 8 East Main Street, Beijing, 100071, China

    Ning Lu, Li-Li Wang, Yu-Yan Li, Li-Jun Wang, Chun-Ji Gao, Dai-Hong Liu & Xiao-Ning Gao

  2. Institute of Basic Medicine, Graduate School, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China

    Ji Lin

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  1. Ning Lu
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  2. Ji Lin
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Lu, N., Lin, J., Wang, LL. et al. A retrospective single-center analysis of G-CSF-mobilized donor lymphocyte infusion in hematologic malignancies after unmanipulated allogenic PBSCT. Int J Hematol 115, 713–727 (2022). https://doi.org/10.1007/s12185-022-03298-9

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