Administration of short-term immunosuppressive agents after DLI reduces the incidence of DLI-associated acute GVHD without influencing the GVL effect.
Donor lymphocyte infusion (DLI) exerts a GVL effect, but its use is limited by a high incidence of GVHD. We retrospectively evaluated the efficacy of administering short-term immunosuppressive agents for prophylaxis against DLI-associated acute GVHD, and its influence on the GVL effect. Seventy patients with leukaemia received G-CSF primed DLI after HLA-identical sibling haematopoietic stem cell transplantation (HSCT) for treatment or prophylaxis against leukaemia relapse. Short-term immunosuppressive agents were given to 54 patients for prophylaxis against DLI-associated acute GVHD. Seventeen patients experienced acute GVHD; 30 patients developed chronic GVHD; and no GVHD-related death was observed. A significant difference was observed between the group that did not receive prophylaxis against GVHD or received prophylaxis for less than 2 weeks and the group that received prophylaxis for over 2 weeks (CsA or MTX at 10 mg/week) with regard to the incidence of DLI-associated acute GVHD (14/28 vs 3/42, P=0.000); no difference was observed in the relapse rate for prophylactic DLI patients between the two groups (4/10 vs 12/29). Using immunosuppressive agents for 2-4 weeks may reduce DLI-associated acute GVHD without influencing relapse and survival after G-CSF-primed DLI.
Huang
X-J
XJ
Peking University People's Hospital, Peking University Institute of Hematology, Beijing, People's Republic of China. xjhrm@medmail.com.cn
Wang
Y
Y
Liu
D-H
DH
Xu
L-P
LP
Liu
K-Y
KY
Chen
H
H
Chen
Y-H
YH
Han
W
W
Shi
H-X
HX
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000517:prevention & control*; D020544:Graft vs Leukemia Effect / Q000187:drug effects* / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000276:immunology; D007938:Leukemia / Q000276:immunology / Q000628:therapy*; D017708:Leukocyte Transfusion / Q000379:methods*; D008214:Lymphocytes / Q000166:cytology / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D007166:Immunosuppressive Agents