title: Efficacy of adoptive immunotherapy with donor lymphocyte infusion in relapsed lymphoid malignancies.
abstract: OBJECTIVE
  There is a perceived benefit associated with the administration of donor lymphocyte infusion (DLI) in patients with lymphoid malignancies relapsing after allogeneic hematopoietic cell transplantation. However, it is unclear if and how this benefit varies according to specific diseases. Because administration of DLI is not universally effective and could be associated with significant toxicities resulting in morbidity and mortality, it is imperative to identify cases where benefits outweigh harms of the procedure.
  
  
  METHODS
  We conducted a systematic review of the published literature and extracted and pooled data independently for each disease cohort: acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL), multiple myeloma (MM), non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL).
  
  
  RESULTS
  In summary, 39 studies met inclusion criteria. The pooled proportion (95% CI) for complete response was 27% (16-40) in ALL, 55% (15-92) in CLL, 26% (19-33) in MM, 52% (33-71) in NHL and 37% (20-56) in HL.
  
  
  CONCLUSIONS
  Complete response rates appear higher when DLI is used for relapsed CLL and lymphomas (NHL and HL), and less pronounced in ALL or MM. Absence of data pertaining to disease-specific prognostic determinants, such as adverse genetic or molecular abnormalities, or quantitative disease burden when applicable, limit our ability to identify cases in whom benefits from DLI outweigh risks associated with the procedure within a particular disease.
authors: Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
authors: Najla
authors: N
authors: El-Jurdi
authors: Tea
authors: T
authors: Reljic
authors: Ambuj
authors: A
authors: Kumar
authors: Joseph
authors: J
authors: Pidala
authors: Ali
authors: A
authors: Bazarbachi
authors: Benjamin
authors: B
authors: Djulbegovic
authors: Mohamed A
authors: MA
authors: Kharfan-Dabaja
mesh_terms: D006801:Humans; D016219:Immunotherapy, Adoptive / Q000379:methods*; D007938:Leukemia / Q000276:immunology / Q000628:therapy*; D017710:Lymphocyte Transfusion / Q000706:statistics & numerical data*; D008223:Lymphoma / Q000276:immunology / Q000628:therapy*; D009101:Multiple Myeloma / Q000276:immunology / Q000628:therapy*; D016896:Treatment Outcome