Modified Donor Lymphocyte Infusion after HLA-Mismatched/Haploidentical T Cell-replete Hematopoietic Stem Cell Transplantation for Prophylaxis of Relapse of Leukemia in Patients with Advanced Leukemia
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We evaluated the safety and efficacy of donor lymphocyte infusion (DLI) with granulocyte colony-stimulating factor priming and short-term immunosuppressive agents for prophylaxis of relapse in patients with advanced leukemia after human leukocyte antigen (HLA)-mismatched T cell-replete hematopoietic stem cell transplantation (HCT). Twenty-nine patients received prophylactic DLI at a median 75 (33–120) days after HCT. Acute graft-vs-host disease (GVHD) grades 3–4 occurred in six patients, and all cases were controlled. Eleven patients were alive and relapse-free with a probability of leukemia-free survival (LFS) of 37.3 ± 9.6% at 3 years. Chronic GVHD was associated with a lower relapse rate and higher probability of LFS. Prophylactic-modified DLI is feasible in patients with advanced leukemia to prevent relapse after HLA-mismatched HCT.
KeywordsDonor lymphocyte infusion HLA-mismatched transplantation haploidentical HSCT GVHD relapse DLI
This work is supported by the National Outstanding Young Scientist’s Foundation of China (grant no. 30725038), Hi-tech Research and Development Program of China (no. 2006AA02Z4A0), and Program for Innovative Research Team in the University (No. IRT0702).
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