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Value of Donor Lymphocyte Infusions Studied

Biol Blood Marrow Transplant; ePub 2017 Jul 13; Caldemeyer, et al

Among patient with hematologic malignancies, donor lymphocyte infusions (DLI) appear to protect against post HSCT-relapse in those with mixed chimerism (MC), according to a retrospective study involving 86 individuals.

Participants were given DLI for relapsed/residual (RR) disease (n=50); emerging MC without detectable disease (n=29); or for other reasons (n=7). Investigators looked at safety and efficacy of DLI given via a dose-escalation protocol. Among the results:

  • After DLI, 93% of patients with MC converted to full donor chimerism (FDC).
  • Patients with MC who did not relapse had 1- and 5-year overall survival rates of 83% and 70%, respectively.
  • Improved survival correlated with successful conversion to FDC after DLI in both the RR and MC cohorts.
  • DLI for non-relapsed patients was linked with a superior 5-year progression free survival of 71%, vs 18% in the RR group.
  • Relapse/progressive disease was the most frequent cause of death, occurring in 41%.

Citation:

Caldemeyer L, Akard L, Edwards J, Tandra A, Wagenknecht D, Dugan M. Donor lymphocyte infusions used to treat mixed chimeric and high-risk patient populations in the relapsed and non-relapsed settings after allogeneic transplant for hematologic malignancies are associated with high 5-year survival if persistent full donor chimerism is obtained or maintained. [Published online ahead of print July 13, 2017]. Biol Blood Marrow Transplant. doi:10.1016/j.bbmt.2017.07.007.