title: Adoptive therapy with donor lymphocyte infusion after allogenic hematopoietic SCT in pediatric patients.
abstract: The aim of this study was to analyse the experience of Polish Pediatric Group for Hematopoietic Stem Cell Transplantation in respect to donor lymphocyte infusion procedure. The study included 51 pediatric patients with malignant (45) and non-malignant (6) diseases treated with DLI in the period 1993-2012. The indications for DLI were as follows: (1) increasing recipient chimerism after non-ablative hematopoietic SCT (18 patients); (2) immunomodulation after a reduced intensity conditioning regimen (2 patients); (3) increase in minimal residual disease detection (3 patients); and (4) relapse (28 patients). DLI was carried out at a median of 6 (0.5-79) months after SCT. DLI was administered as either a single-dose (in 19 cases) or in escalating-dose regimens (in 32 cases). The median total dose of CD3-positive T cells was 28.0 (0.1-730.0) × 10(6)/kg body weight. The time for assessment of DLI efficacy ranged from 0 to 70 (median 3) months. At evaluation, 18 patients experienced CR, 3 achieved PR, 19 showed relapse and 11 rejected the graft. DLI was found to be effective in 39% of cases. Complications of the procedure occurred in 18 patients; of these, 2 died. To sum up DLI shows efficacy in a significant percentage of children. Mortality related to the therapy adverse effects is low. However, this method requires standardization.
authors.affiliation: 1] Department of Clinical Immunology and Transplantation, Polish-American Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland [2] Department of Transplantation, Children's University Hospital in Krakow, Krakow, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Gozdzik
authors.affiliation: Department and Clinic of Bone Marrow Transplantation, Pediatrics Oncology and Hematology, Medical University in Wroclaw, Wroclaw, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Rewucka
authors.affiliation: 1] Department of Clinical Immunology and Transplantation, Polish-American Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland [2] Department of Transplantation, Children's University Hospital in Krakow, Krakow, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Krasowska-Kwiecien
authors.affiliation: Department and Clinic of Pediatrics Oncology, Hematology and Transplantation, Medical University in Poznan, Poznan, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Pieczonka
authors.affiliation: Department of Pediatrics, Hematology and Oncology, Nicolaus Copernicus University, Medical College in Bydgoszcz, Bydgoszcz, Poland.
authors.forename: R
authors.initials: R
authors.lastname: Debski
authors.affiliation: Department of Pediatric Hematology, Oncology and Transplantology, Medical University in Lublin, Lublin, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Zaucha-Prazmo
authors.affiliation: Department of Pediatric Hematology, Oncology and Transplantology, Medical University in Lublin, Lublin, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Drabko
authors.affiliation: Department and Clinic of Bone Marrow Transplantation, Pediatrics Oncology and Hematology, Medical University in Wroclaw, Wroclaw, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Krukowska-Jaros
authors.affiliation: Department of Transplantation, Children's University Hospital in Krakow, Krakow, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Wozniak
authors.affiliation: Department of Pediatric Hematology, Oncology and Transplantology, Medical University in Lublin, Lublin, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Kowalczyk
authors.affiliation: Department of Pediatrics, Hematology and Oncology, Nicolaus Copernicus University, Medical College in Bydgoszcz, Bydgoszcz, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Wysocki
authors.affiliation: Department and Clinic of Bone Marrow Transplantation, Pediatrics Oncology and Hematology, Medical University in Wroclaw, Wroclaw, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Gorczynska
authors.affiliation: Department and Clinic of Bone Marrow Transplantation, Pediatrics Oncology and Hematology, Medical University in Wroclaw, Wroclaw, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Kalwak
authors.affiliation: Department and Clinic of Bone Marrow Transplantation, Pediatrics Oncology and Hematology, Medical University in Wroclaw, Wroclaw, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Chybicka
authors.affiliation: Department and Clinic of Pediatrics Oncology, Hematology and Transplantation, Medical University in Poznan, Poznan, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Wachowiak
mesh_terms: D064591:Allografts; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019520:Living Donors; D017710:Lymphocyte Transfusion; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate