title: Prevention of relapse using granulocyte CSF-primed PBPCs following HLA-mismatched/haploidentical, T-cell-replete hematopoietic SCT in patients with advanced-stage acute leukemia: a retrospective risk-factor analysis.
abstract: The role of donor lymphocyte infusion (DLI) in the prophylaxis of relapse has not been defined. We retrospectively analyzed the data from 88 patients with advanced-stage acute leukemia after HLA-mismatched/haploidentical hematopoietic SCT (HSCT) whose treatment did (n=61) or did not (n=27) include granulocyte CSF (GCSF)-primed PBPCs infusion (GPBPCI). The two groups were compared with respect to relapse and OS. Further, a detailed analysis of risk factors was performed. The 2-year cumulative incidence of relapse in patients receiving prophylactic GPBPCI and not receiving prophylactic GPBPCI were 36% and 55% (P=0.017), respectively. Estimated survival at 3 years was 31% for patients receiving prophylactic GPBPCI and 11% for patients not receiving prophylactic GPBPCI (P=0.001). The three-year probability of leukemia-free survival was also higher in patients who received prophylactic GPBPCI (22%) compared with patients who did not (11%) (P=0.003). Multivariate analysis for relapse showed that use of prophylactic GPBPCI after transplantation was an independent prognostic factor (P=0.025). Higher OS was associated with use of prophylactic GPBPCI (P=0.002), AML (P=0.027) and female sex (P=0.023). Our results suggest that use of prophylactic GPBPCI may increase survival of patients with advanced-stage acute leukemia who receive HLA-mismatched/haploidentical HSCT.
authors: Peking University People's Hospital, Institute of Hematology, No.11Xizhimen South Street, Xicheng, Beijing, China.
authors: Y
authors: Y
authors: Wang
authors: D-H
authors: DH
authors: Liu
authors: L-P
authors: LP
authors: Xu
authors: K-Y
authors: KY
authors: Liu
authors: H
authors: H
authors: Chen
authors: X-H
authors: XH
authors: Zhang
authors: Y-H
authors: YH
authors: Chen
authors: W
authors: W
authors: Han
authors: F-R
authors: FR
authors: Wang
authors: J-Z
authors: JZ
authors: Wang
authors: C-H
authors: CH
authors: Yan
authors: X-J
authors: XJ
authors: Huang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007938:Leukemia / Q000401:mortality* / Q000517:prevention & control*; D017710:Lymphocyte Transfusion; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D013997:Time Factors; D014184:Transplantation, Homologous
chemical_list: D016179:Granulocyte Colony-Stimulating Factor