Annals of Hematology

, Volume 96, Issue 5, pp 829–838 | Cite as

Comparison of outcomes after donor lymphocyte infusion with or without prior chemotherapy for minimal residual disease in acute leukemia/myelodysplastic syndrome after allogeneic hematopoietic stem cell transplantation

  • Xiao-Dong Mo
  • Xiao-Hui Zhang
  • Lan-Ping Xu
  • Yu Wang
  • Chen-Hua Yan
  • Huan Chen
  • Yu-Hong Chen
  • Wei Han
  • Feng-Rong Wang
  • Jing-Zhi Wang
  • Kai-Yan Liu
  • Xiao-Jun Huang
Original Article

Abstract

The efficacy of donor lymphocyte infusion (DLI) without chemotherapy was investigated and compared with that of chemotherapy prior to DLI (Chemo-DLI) in patients who were minimal residual disease (MRD)-positive after allogeneic hematopoietic stem cell transplantation (HSCT). We enrolled 115 consecutive patients who received either DLI (n = 20) or Chemo-DLI (n = 95) during the same period. For each DLI recipient, three recipients matched for age at the HSCT, underlying diseases, and the year of the HSCT were randomly selected from the Chemo-DLI cohort (n = 60). The 2-year cumulative incidence of severe acute graft-versus-host disease (GVHD) and chronic GVHD was comparable between the groups. Fifteen (75.0%) and 47 (78.3%) patients in the DLI and Chemo-DLI groups turned MRD-negative, respectively. The 2-year cumulative incidences of relapse and non-relapse mortality after intervention were 30.7 versus 39.6% (P = 0.582) and 10.3 versus 6.0% (P = 0.508) in the DLI and Chemo-DLI groups, respectively. The 2-year probabilities of disease-free, overall, and GVHD-free/relapse-free survival after preemptive intervention were 58.9 versus 54.3% (P = 0.862), 69.3 versus 78.1% (P = 0.361), and 44.4 versus 35.1% (P = 0.489) in the DLI and Chemo-DLI groups, respectively. In multivariate analysis, the intervention method did not significantly influence the clinical outcomes. In summary, preemptive DLI alone may be effective for patients who are MRD-positive and may be a potential alternative for patients who refuse or are unable to receive Chemo-DLI after HSCT.

Keywords

Preemptive Donor lymphocyte infusion Hematopoietic stem cell transplantation Minimal residual disease Chemotherapy 

Notes

Acknowledgements

We would like to thank Editage for providing editorial assistance. This work was supported by the National Natural Science Foundation of China (No. 81400145), the Beijing Talents fund (No. 2015000021223ZK39), the Key Program of the National Natural Science Foundation of China (No. 81530046), and the Foundation for Innovative Research Groups of the National Natural Science Foundation of China (No. 81621001).

Compliance with ethical standards

Informed consent was obtained from all patients or the patients’ guardians, and the study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of Peking University People’s Hospital.

Conflicts of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Xiao-Dong Mo
    • 1
  • Xiao-Hui Zhang
    • 1
  • Lan-Ping Xu
    • 1
  • Yu Wang
    • 1
  • Chen-Hua Yan
    • 1
  • Huan Chen
    • 1
  • Yu-Hong Chen
    • 1
  • Wei Han
    • 1
  • Feng-Rong Wang
    • 1
  • Jing-Zhi Wang
    • 1
  • Kai-Yan Liu
    • 1
  • Xiao-Jun Huang
    • 1
    • 2
    • 3
  1. 1.Peking University People’s Hospital, Peking University Institute of HematologyBeijingChina
  2. 2.Peking-Tsinghua Center for Life SciencesBeijingChina
  3. 3.Beijing Key Laboratory of Hematopoietic Stem Cell TransplantationBeijingChina

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