title: Modified donor lymphocyte infusion-associated acute graft-versus-host disease after haploidentical T-cell-replete hematopoietic stem cell transplantation: incidence and risk factors.
abstract: We performed a study to investigate the profile of donor lymphocyte infusion (DLI)-associated acute graft-versus-host disease (GVHD) in haploidentical T-cell-replete hematopoietic stem cell transplantation (HSCT). A total of 124 patients receiving modified DLI after haploidentical T-cell-replete HSCT were enrolled. The cumulative incidence of DLI-associated acute GVHD was 53.2% for grades II-IV and 28.4% for grades III-IV. The duration of GVHD prophylaxis after DLI was the only risk factor for DLI-associated grades III-IV acute GVHD (p<0.05). The cumulative incidence of grades III-IV acute GVHD in patients with prophylaxis more than six, four to six, two to four, and <2 wk were 9.3%, 14.4%, 31.6%, and 49.5%, respectively (p=0.018). Furthermore, DLI-associated grades III-IV acute GVHD was the only risk factor for overall survival (p=0.038, OR=2.869) and transplant-related mortality (p=0.018, OR=3.296) but not a risk factor for relapse after DLI (p=0.840). This study confirms for the first time that the duration of GVHD prophylaxis after DLI is the only risk factor for the development of grades III-IV acute GVHD. Donor lymphocyte infusion with prophylaxis more than six wk was associated with a lower incidence of grades III-IV acute GVHD.
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
authors.forename: Chen-Hua
authors.initials: CH
authors.lastname: Yan
authors.forename: Dai-Hong
authors.initials: DH
authors.lastname: Liu
authors.forename: Lan-Ping
authors.initials: LP
authors.lastname: Xu
authors.forename: Kai-Yan
authors.initials: KY
authors.lastname: Liu
authors.forename: Ting
authors.initials: T
authors.lastname: Zhao
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.forename: Huan
authors.initials: H
authors.lastname: Chen
authors.forename: Yu-Hong
authors.initials: YH
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Han
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D017710:Lymphocyte Transfusion; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014019:Tissue Donors; D014184:Transplantation, Homologous; D055815:Young Adult