Donor Lymphocyte Infusion in Hematologic Malignancies—Good to be Fresh?

Hossain, Nasheed; Klumpp, Thomas R.; Ulicny, John; Garner, Michael; Kropf, Patricia; Mangan, Kenneth F.; Barta, Stefan K.; Fung, Henry C.; Martin, Mary Ellen

doi:10.1016/j.clml.2015.10.004

Cited by 7 publications

(8 citation statements)

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“…Hossain reported a series of 63 patients (including 36 with myeloid malignancies, 13 with ALL), of which 40 received gDLI and 13 received classical DLI. No difference between classical DLI and gDLI was shown in the entire cohort (median OS 3.8 versus 4.6 months) but the AML/MDS subgroup had a trend for better outcomes with gDLI (4.1 versus 2.7 months, p = 0.16); the rate of grade 3–4 GvHD was high (47.6%) [ 29 ]. Hasskarl reported 121 cases of gDLI, 52.1% of myeloid malignancies, 14% of ALL, 10.7% of lymphoma and 8.3% of myeloma, 66.9% for relapse, 4% for detectable MRD, 18.2% for mixed chimerism and 10.7% for high relapse risk.…”

Section: Discussionmentioning

confidence: 99%

“…Considering all patients, the median PFS was 9 months (3-35), 5-year PFS was 38% (29-47), the median OS was 22 months (6-50) and 5-year OS was 37% (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47). Eighty-two deaths were recorded: 47.1% due to progression of the malignancy, 10.1% due to toxicity of the DLI (GvHD and infection) and three deaths from other causes.…”

Section: Survivalmentioning

confidence: 99%

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A Retrospective Comparison of DLI and gDLI for Post-Transplant Treatment

Lamure

Paul

Gagez

et al. 2020

JCM

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Donor lymphocyte infusion (DLI) is used to prevent or treat haematological malignancies relapse after allogeneic stem cell transplantation (allo-SCT). Recombinant human granulocyte colony-stimulated factor primed DLI (gDLI) is derived from frozen aliquots of the peripheral blood stem cell collection. We compared the efficacy and safety of gDLI and classical DLI after allo-SCT. We excluded haploidentical allo-SCT. Initial diseases were acute myeloblastic leukaemia (n = 45), myeloma (n = 38), acute lymphoblastic leukaemia (n = 20), non-Hodgkin lymphoma (n = 10), myelodysplasia (n = 8), Hodgkin lymphoma (n = 8), chronic lymphocytic leukaemia (n = 7), chronic myeloid leukaemia (n = 2) and osteomyelofibrosis (n = 1). Indications for DLI were relapse (n = 96) or pre-emptive treatment (n = 43). Sixty-eight patients had classical DLI and 71 had gDLI. The response rate was 38.2%, the 5-year progression-free survival (PFS) rate was 38% (29–48) and the 5-year overall survival (OS) rate was 37% (29–47). Graft versus host disease rate was 46.7% and 10.1% of patients died from toxicity. There were no differences between classical DLI and gDLI in terms of response (p = 0.28), 5-year PFS (p = 0.90), 5-year OS (p. 0.50), GvHD (p = 0.86), treated GvHD (p = 0.81) and cause of mortality (p. 0.14). In conclusion, this study points out no major effectiveness or toxicity of gDLI compared to classical DLI.

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Section: Discussionmentioning

confidence: 99%

Section: Survivalmentioning

confidence: 99%

A Retrospective Comparison of DLI and gDLI for Post-Transplant Treatment

Lamure

Paul

Gagez

et al. 2020

JCM

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“…These results indicate the importance of serial evaluations for minimal residual disease to predict early relapse after allo-HSCT. In case of minimal residual disease, therapeutic intervention with tapering or discontinuation of immunosuppressants, followed by DLI, or with chemotherapy, molecular-targeted therapy, or combination therapy should be immediately initiated [6][7][8]25].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, because mortality associated with a second allo-HSCT for relapsed recipients is considered to be much higher, DLI therapy may represent a viable alternative to second allo-HSCT. Thus, DLI has been applied in the treatment of various hematological malignancies [6][7][8], such as leukemias [9,10], lymphoma [11][12][13], and myeloma [14,15]. In particular, patients who have relapsed after unrelated allo-HSCT because of lack of HLA-matched related sibling donors may also benefit from unrelated DLI (UDLI) [16].…”

Section: Introductionmentioning

confidence: 99%

Donor Lymphocyte Infusion for Relapsed Hematological Malignancies after Unrelated Allogeneic Bone Marrow Transplantation Facilitated by the Japan Marrow Donor Program

Miyamoto

Fukuda²,

Nakashima³

et al. 2017

Biology of Blood and Marrow Transplantation

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To evaluate the safety and efficacy of donor lymphocyte infusion (DLI), we retrospectively analyzed 414 recipients who received unrelated DLI (UDLI) for the treatment of relapsed hematological malignancy after unrelated bone marrow transplantation (BMT). UDLI was administered for acute myelogenous leukemia (n = 184), myelodysplastic syndrome (n = 69), acute lymphocytic leukemia (n = 57), chronic myelogenous leukemia (CML, n = 36), lymphoid neoplasms (n = 38), adult T cell leukemia/lymphoma (n = 18), and multiple myeloma (n = 12). Sixty-five patients (16%) were in cytogenetic/molecular relapse and 349 (84%) were in hematological relapse after BMT. In total, 266 out of 414 (64%) patients received chemotherapy and/or molecular-targeted agents in combination with UDLI. The median time from BMT to UDLI was 244 days. The median number of infused CD3 cells was 3.51 × 10/kg. Response and survival rates were evaluated at 100 days after UDLI. Complete response was obtained in 37 (57%) of 65 patients with cytogenetic/molecular relapse and in 69 (20%) of 349 patients with hematological relapse (P < .001). Two hundred forty-seven patients (60%) were alive, whereas 110 (26%) had died because of disease progression, 26 (6%) because of infections, 12 (3%) because of graft-versus-host disease (GVHD), and 13 (3%) because of organ failure. Multivariate analysis identified molecular/cytogenetic relapse, GVHD after UDLI, and CML but not combination with chemotherapy as significant prognostic factors. These results indicate that UDLI may have efficacy in relapsed patients with CML, low tumor burden, or occurrence of GVHD after UDLI.

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“…DLI viability might be affected after cryopreservation and this could alter its effectiveness or toxicity. A group from Philadelphia [62] performed a retrospective analysis of 63 patients who received fresh or cryopreserved DLI. They did find similar outcomes when comparing both cohorts, although the small numbers suggest that further evidence is needed.…”

Section: Fresh or Cryopreserved?mentioning

confidence: 99%