title: [Donor lymphocyte infusion for treatment of relapse of leukemia after HLA-mismatched hematopoietic stem cell transplantation].
abstract: OBJECTIVE
  To observe the efficacy and safety of donor lymphocyte infusion (DLI) for treatment of leukemia relapse after HLA-mismatched hematopoietic stem cell transplantation (HSCT).
  
  
  METHODS
  Patients received DLI were studied for the occurrence of graft-versus-host disease (GVHD) , remission of leukemia and long-term survival after granulocyte colony-stimulating factor (G-CSF). G-CSF-primed DLI and GVHD prophylaxis (some received chemotherapy).
  
  
  RESULTS
  Acute grade III - IV GVHD was observed in 8 of 24 patients relapsed after HSCT and GVHD prophylaxis reduced the incidence (P = 0.013). Eight patients developed chronic GVHD and myelosuppression in three patients. Sixteen of twenty-four patients achieved complete remission. Nine of them survived leukemia-free for a median of 1310 (961 - 1914) days after HSCT. The 1-year and 2-year probability of leukemia-free survival was 60% and 40%, respectively. The number of blasts influenced on remission and survival. Occurrence of extensive chronic GVHD was related to higher remission rate (P = 0.046). All three patients with Ph-positive acute lymphoblastic leukemia died of relapse.
  
  
  CONCLUSIONS
  The G-CSF-primed DLI with GVHD prophylaxis(some combined with chemotherapy) is a potentially effective therapeutic option for patients with relapsed leukemia after HLA-mismatched HSCT.
authors.affiliation: Institute of Hematology, People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Dai-Hong
authors.initials: DH
authors.lastname: Liu
authors.forename: Kai-Yan
authors.initials: KY
authors.lastname: Liu
authors.forename: Lan-Ping
authors.initials: LP
authors.lastname: Xu
authors.forename: Wei
authors.initials: W
authors.lastname: Han
authors.forename: Huan
authors.initials: H
authors.lastname: Chen
authors.forename: Yu-Hong
authors.initials: YH
authors.lastname: Chen
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Zhang
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000517:prevention & control; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006680:HLA Antigens; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D017710:Lymphocyte Transfusion; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D055815:Young Adult
chemical_list: D006680:HLA Antigens; D016179:Granulocyte Colony-Stimulating Factor