Modified donor lymphocyte infusion after HLA-mismatched/haploidentical T cell-replete hematopoietic stem cell transplantation for prophylaxis of relapse of leukemia in patients with advanced leukemia.
We evaluated the safety and efficacy of donor lymphocyte infusion (DLI) with granulocyte colony-stimulating factor priming and short-term immunosuppressive agents for prophylaxis of relapse in patients with advanced leukemia after human leukocyte antigen (HLA)-mismatched T cell-replete hematopoietic stem cell transplantation (HCT). Twenty-nine patients received prophylactic DLI at a median 75 (33-120) days after HCT. Acute graft-vs-host disease (GVHD) grades 3-4 occurred in six patients, and all cases were controlled. Eleven patients were alive and relapse-free with a probability of leukemia-free survival (LFS) of 37.3 +/- 9.6% at 3 years. Chronic GVHD was associated with a lower relapse rate and higher probability of LFS. Prophylactic-modified DLI is feasible in patients with advanced leukemia to prevent relapse after HLA-mismatched HCT.
Huang
Xiao-Jun
XJ
Institute of Hematology, People's Hospital, Peking University, no. 11 Xizhimen South Street, 100044 Beijing, People's Republic of China. xjhrm@medmail.com.cn
Liu
Dai-Hong
DH
Liu
Kai-Yan
KY
Xu
Lan-Ping
LP
Chen
Yu-Hong
YH
Wang
Yu
Y
Han
Wei
W
Chen
Huan
H
D000293:Adolescent; D000328:Adult; D001804:Blood Transfusion, Autologous; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease; D006680:HLA Antigens / Q000235:genetics*; D018380:Hematopoietic Stem Cell Transplantation; D006650:Histocompatibility Testing; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000276:immunology / Q000517:prevention & control*; D008212:Lymphocyte Depletion; D017710:Lymphocyte Transfusion; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D013601:T-Lymphocytes / Q000276:immunology / Q000637:transplantation*
D006680:HLA Antigens