[Donor lymphocyte infusion for treatment of relapse of leukemia after HLA-mismatched hematopoietic stem cell transplantation].
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.
Liu
Dai-Hong
DH
Institute of Hematology, People's Hospital, Peking University, Beijing 100044, China.
Liu
Kai-Yan
KY
Xu
Lan-Ping
LP
Han
Wei
W
Chen
Huan
H
Chen
Yu-Hong
YH
Zhang
Xiao-Hui
XH
Huang
Xiao-Jun
XJ
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
D006680:HLA Antigens; D016179:Granulocyte Colony-Stimulating Factor