title: Prevention of relapse using DLI can increase survival following HLA-identical transplantation in patients with advanced-stage acute leukemia: a multi-center study.
abstract: A total of 123 consecutive patients with advanced-stage, acute leukemia undergoing HSCT from HLA-identical sibling donors were analyzed. A G-CSF-primed DLI was planned within day 60 post-transplantation before hematologic relapse was diagnosed. Fifty of the 123 individuals received prophylactic DLI, and 73 individuals received no prophylactic treatment. The incidence of grades II-IV acute graft-versus-host disease (GVHD) was 17% for patients receiving DLI and 23% for patients not receiving DLI (p = 0.35). The incidence of chronic GVHD was 38% for patients receiving DLI and 17% for patients not receiving DLI (p = 0.021). The two-yr cumulative incidence of relapse was significantly lower in patients who received prophylactic DLI (46%) compared with patients who did not receive prophylactic DLI (66%) (p = 0.02). The three-yr probability of overall survival was higher in patients who received prophylactic DLI (36%) than in patients who did not receive prophylactic DLI (11%) (p = 0.001). The leukemia-free survival was also higher in patients who received prophylactic DLI (29%) than in patients who did not receive prophylactic DLI (9%) (p = 0.001). Our comparisons suggest that the prophylactic use of DLI can significantly increase survival of patients with advanced-stage, acute leukemia who receive HLA-identical sibling HSCT.
authors.affiliation: Peking University People's Hospital, Institute of Hematology, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.forename: Dai-Hong
authors.initials: DH
authors.lastname: Liu
authors.forename: Zhi-Ping
authors.initials: ZP
authors.lastname: Fan
authors.forename: Jing
authors.initials: J
authors.lastname: Sun
authors.forename: Xiao-Jin
authors.initials: XJ
authors.lastname: Wu
authors.forename: Xiao
authors.initials: X
authors.lastname: Ma
authors.forename: Lan-Ping
authors.initials: LP
authors.lastname: Xu
authors.forename: Kai-Yan
authors.initials: KY
authors.lastname: Liu
authors.forename: Qi-Fa
authors.initials: QF
authors.lastname: Liu
authors.forename: De-Pei
authors.initials: DP
authors.lastname: Wu
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D020544:Graft vs Leukemia Effect; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006680:HLA Antigens / Q000276:immunology*; D006648:Histocompatibility; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D017708:Leukocyte Transfusion; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000276:immunology / Q000401:mortality / Q000517:prevention & control*; D036102:Peripheral Blood Stem Cell Transplantation; D011379:Prognosis; D035781:Siblings; D015996:Survival Rate; D013601:T-Lymphocytes / Q000276:immunology; D014019:Tissue Donors / Q000706:statistics & numerical data; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D006680:HLA Antigens; D016179:Granulocyte Colony-Stimulating Factor