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Frontiers of Medicine

, Volume 13, Issue 3, pp 354–364 | Cite as

Minimal residual disease-directed immunotherapy for high-risk myelodysplastic syndrome after allogeneic hematopoietic stem cell transplantation

  • Xiaodong Mo
  • Xiaohui Zhang
  • Lanping Xu
  • Yu Wang
  • Chenhua Yan
  • Huan Chen
  • Yuhong Chen
  • Wei Han
  • Fengrong Wang
  • Jingzhi Wang
  • Kaiyan Liu
  • Xiaojun HuangEmail author
Research Article
  • 37 Downloads

Abstract

The efficacy of minimal residual disease (MRD)-directed immunotherapy, including interferon-α (IFN- α) treatment and chemotherapy plus granulocyte colony-stimulating factor-primed donor leukocyte infusion (chemo-DLI), was investigated in patients with high-risk myelodysplastic syndrome (MDS) who were MRD-positive after allogeneic hematopoietic stem cell transplantation (allo-HSCT). High-risk MDS patients who received non-T-cell-depleted allo-HSCT at the Peking University Institute of Hematology and were MRD-positive after allo-HSCT were studied (n = 47). The MRD-positive status was considered if leukemia-associated aberrant immune phenotypes or Wilms’ tumor gene 1 expression is present in a single bone marrow sample. The cumulative incidence of the relapse and non-relapse mortality 2 years after immunotherapy were 14.5% and 21.4% (P = 0.377) and 9.1% and 0.0% (P = 0.985) for patients in the IFN-α and chemo-DLI groups, respectively. The probability of disease-free and overall survival 2 years after immunotherapy were 76.4% and 78.6% (P = 0.891) and 84.3% and 84.6% (P = 0.972) for patients in the IFN-α and chemo-DLI groups, respectively. Persistent MRD after immunotherapy was associated with poor survival. Thus, the MRD-directed immunotherapy was effective for patients with high-risk MDS who were MRD-positive after allo-HSCT, and the efficacy was comparable between chemo-DLI and IFN-α treatment.

Keywords

donor leukocyte infusion hematopoietic stem cell transplantation interferon-α minimal residual disease myelodysplastic syndrome 

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Notes

Acknowledgements

The authors thank Editage for their English editing assistance as well as Drs. Daoxing Deng, Yujia Chi, andWei Guo for their assistance in data collection. This work was supported by the Capital’s Funds for Health Improvement and Research (No. 2018-4-4089), the Key Program of the National Natural Science Foundation of China (No. 81530046), Foundation for Innovative Research Groups of the National Natural Science Foundation of China (No. 81621001), the Science and Technology Project of Guangdong Province of China (No. 2016B030230003), the National Science and Technology Support Program (No. 2014BAI09B13), and the Project of Health Collaborative Innovation of Guangzhou city (No. 201704020214).

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Copyright information

© Higher Education Press and Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Xiaodong Mo
    • 1
  • Xiaohui Zhang
    • 1
  • Lanping Xu
    • 1
  • Yu Wang
    • 1
  • Chenhua Yan
    • 1
  • Huan Chen
    • 1
  • Yuhong Chen
    • 1
  • Wei Han
    • 1
  • Fengrong Wang
    • 1
  • Jingzhi Wang
    • 1
  • Kaiyan Liu
    • 1
  • Xiaojun Huang
    • 1
    • 2
    Email author
  1. 1.Peking University People’s Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell TransplantationBeijingChina
  2. 2.Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary StudiesPeking UniversityBeijingChina

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