title: Escalating-dose HLA-mismatched DLI is safe for the treatment of leukaemia relapse following alemtuzumab-based myeloablative allo-SCT.
abstract: Although the feasibility of using HLA-mismatched unrelated donors as an alternate graft source for haematopoietic SCT (HSCT) has been shown, little is known about the safety of HLA-mismatched DLI for the treatment of relapse. We examined the outcome of 58 consecutive leukaemia patients who received escalating-dose DLI for treatment of relapse after alemtuzumab-conditioned myeloablative unrelated donor HSCT at our institution. High-resolution HLA typing on stored DNA samples revealed mismatches in 28/58 patients who were considered HLA-matched at the time of transplantation. Following DLI from HLA-matched (10/10) (n=30) or -mismatched (7-9/10) (n=28) unrelated donors, we found no significant difference in the incidence of acute GVHD (17.2% versus 23.1%, P=0.59), probability of remission at 3 years (62.1% versus 63.9%, P=0.89) or 5-year OS (89.8% versus 77.7%, P=0.22). We conclude that escalating-dose DLI can be safely given to HLA-mismatched recipients following T-depleted myeloablative HSCT.
authors.affiliation: Centre for Haematology, Faculty of Medicine, Imperial College London, London, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Innes
authors.forename: R
authors.initials: R
authors.lastname: Beattie
authors.forename: R
authors.initials: R
authors.lastname: Sergeant
authors.forename: G
authors.initials: G
authors.lastname: Damaj
authors.forename: L
authors.initials: L
authors.lastname: Foroni
authors.forename: D
authors.initials: D
authors.lastname: Marin
authors.forename: E
authors.initials: E
authors.lastname: Kanfer
authors.forename: S
authors.initials: S
authors.lastname: Mielke
authors.forename: D
authors.initials: D
authors.lastname: Milojkovic
authors.forename: D
authors.initials: D
authors.lastname: MacDonald
authors.forename: J
authors.initials: J
authors.lastname: Pavlu
authors.forename: A
authors.initials: A
authors.lastname: Rahemtulla
authors.forename: I
authors.initials: I
authors.lastname: Roberts
authors.forename: D
authors.initials: D
authors.lastname: Slade
authors.forename: E
authors.initials: E
authors.lastname: Bray
authors.forename: J
authors.initials: J
authors.lastname: Goldman
authors.forename: J
authors.initials: J
authors.lastname: Apperley
authors.forename: R
authors.initials: R
authors.lastname: Szydlo
authors.forename: F
authors.initials: F
authors.lastname: Dazzi
authors.forename: K
authors.initials: K
authors.lastname: Rezvani
mesh_terms: D000293:Adolescent; D000328:Adult; D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D006648:Histocompatibility / Q000276:immunology; D006801:Humans; D007938:Leukemia / Q000188:drug therapy / Q000276:immunology / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000276:immunology / Q000628:therapy; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000379:methods*; D013601:T-Lymphocytes / Q000276:immunology / Q000637:transplantation*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D006680:HLA Antigens; D000074323:Alemtuzumab