Efficacy and safety of prophylactic modified donor lymphocyte infusion following allogeneic hematopoietic stem cell transplantation for high-risk acute leukemia

Luxin YANG; Yamin TAN; Jimin SHI; Yanmin ZHAO; Jian YU; Yongxian HU; Xiaoyu LAI; He HUANG; Yi LUO

doi:10.16016/j.1000-5404.201907015

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Efficacy and safety of prophylactic modified donor lymphocyte infusion following allogeneic hematopoietic stem cell transplantation for high-risk acute leukemia

更新时间：2026-01-09

- Efficacy and safety of prophylactic modified donor lymphocyte infusion following allogeneic hematopoietic stem cell transplantation for high-risk acute leukemia
- Journal of Third Military Medical University Vol. 41, Issue 23, Pages: 2267-2271(2019)
- 作者机构：
- 作者简介：
- 基金信息：
  
  the General Program of National Natural Science Foundation of China(81370644)
- DOI：10.16016/j.1000-5404.201907015
  CLC：
- Received：02 July 2019，
  
  Published：25 December 2019
- 稿件说明：
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Luxin YANG, Yamin TAN, Jimin SHI, et al. Efficacy and safety of prophylactic modified donor lymphocyte infusion following allogeneic hematopoietic stem cell transplantation for high-risk acute leukemia[J]. Journal of Third Military Medical University, 2019, 41(23): 2267-2271.
DOI：

Luxin YANG, Yamin TAN, Jimin SHI, et al. Efficacy and safety of prophylactic modified donor lymphocyte infusion following allogeneic hematopoietic stem cell transplantation for high-risk acute leukemia[J]. Journal of Third Military Medical University, 2019, 41(23): 2267-2271. DOI： 10.16016/j.1000-5404.201907015.

摘要

Abstract

Objective

To evaluate the efficacy and safety of prophylactic modified donor lymphocyte infusion (DLI) early after allogeneic hematopoietic stem cell transplantation (allo-HSCT) to prevent the relapse of patients with high-risk acute leukemia.

Methods

We retrospectively analyzed the clinical data of 62 patients with high-risk acute leukemia

who underwent allo-HSCT and received prophylactic modified DLI in our center between January 1

2013 and June 30

2017. All the patients received infusion of recombinant human colony-stimulating factor-primed peripheral blood progenitor cells and short-term immunosuppressant therapy with low-dose closporine A in complete remission (CR) to prevent graft versus host disease (GVHD).

Results

At a median time of 105.5 (59~355) days after the transplantation

the 62 patients received prophylactic modified DLI of a median of 3.95 (0.4~7.6)×10

/kg CD3

cells. The patients were followed up for 3.4~64.7 months (median 33.2 months)

during which 41 patients were alive with CR

17 had relapses

and 21 died. The 3-year probability of overall survival (OS) and leukemia-free survival (LFS) was 69.6% and 63.6% and the 3-year cumulative incidences of relapse and non-relapse mortality (NRM) were 29.7% and 6.7% in these patients

respectively. The incidences of grades Ⅱ~Ⅳ and Ⅲ~Ⅳ acute GVHD at 100 d after DLI were 22.6% and 11.3%

respectively

and the 3-year cumulative incidence of moderate and severe chronic GVHD was 32.9%; the 3-year cumulative GVHD-free and relapse-free survival (GRFS) was 31.7% in these patients.

Conclusion

In patients with high-risk acute leukemia

prophylactic modified DLI early after allo-HSCT is effective for preventing relapse without increasing the incidences of GVHD morbidity or NRM.

关键词

Keywords

references

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