高危急性白血病异基因造血干细胞移植后行预防性改良供者淋巴细胞输注的疗效及安全性分析

杨露欣; 谭亚敏; 施继敏; 赵妍敏; 余建; 胡永仙; 来晓瑜; 黄河; 罗依

doi:10.16016/j.1000-5404.201907015

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高危急性白血病异基因造血干细胞移植后行预防性改良供者淋巴细胞输注的疗效及安全性分析

专题报道：造血干细胞移植与细胞治疗 | 更新时间：2026-01-09

- 高危急性白血病异基因造血干细胞移植后行预防性改良供者淋巴细胞输注的疗效及安全性分析
- Efficacy and safety of prophylactic modified donor lymphocyte infusion following allogeneic hematopoietic stem cell transplantation for high-risk acute leukemia
- 第三军医大学学报 2019年41卷第23期页码：2267-2271
- 作者机构：
- 作者简介：
- 基金信息：
  
  国家自然科学基金面上项目(81370644)
- DOI：10.16016/j.1000-5404.201907015
  中图分类号：
- 收稿：2019-07-02，
  
  纸质出版：2019-12-25
- 稿件说明：
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杨露欣, 谭亚敏, 施继敏, 等. 高危急性白血病异基因造血干细胞移植后行预防性改良供者淋巴细胞输注的疗效及安全性分析[J]. 第三军医大学学报, 2019,41(23):2267-2271.

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.
杨露欣, 谭亚敏, 施继敏, 等. 高危急性白血病异基因造血干细胞移植后行预防性改良供者淋巴细胞输注的疗效及安全性分析[J]. 第三军医大学学报, 2019,41(23):2267-2271. DOI： 10.16016/j.1000-5404.201907015.

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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