DLI after haploidentical BMT with post-transplant CY

Bone Marrow Transplant. 2015 Jan;50(1):56-61. doi: 10.1038/bmt.2014.217. Epub 2014 Oct 13.

Abstract

Forty-two patients relapsing after an unmanipulated haploidentical BM transplant and post-transplant CY (PT-CY), were given 108 DLI, with median interval from transplant of 266 days (range, 67-1372). DLI were given at escalating doses, expressed as CD3+ cells/kg, without GVHD prophylaxis, and ranged from 1 × 10(3) to 1 × 10(7) cells/kg (median 5 × 10(5) cells/kg). The average number of DLI per patient was 2.6 (range, 1-6). The diagnosis was leukemias (n=32) grafted with a myeloablative regimen and Hodgkin's disease (n=10), grafted with a nonmyeloablative regimen. Leukemic patients with molecular relapse (n=20), received DLI alone (n=17) or in association with azacytidine (n=3); leukemic patients with hematologic relapse (n=12) received chemotherapy followed by DLI (n=11) or DLI alone (n=1); Hodgkin patients received DLI following 1-3 courses of chemotherapy. In these three groups the incidence of acute GVHD II-III was 15%, 17% and 10%; response rate was 45%, 33% and 70%; 2-year actuarial survival was 43%, 19% and 80% respectively. This study confirms that escalating doses of DLI can be given in the haploidentical setting with PT-CY, with a relatively low risk of acute GVHD. Response rates and survival are dependent on the underlying disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Allografts
  • Antimetabolites, Antineoplastic / administration & dosage*
  • Azacitidine / administration & dosage*
  • Bone Marrow Transplantation*
  • Disease-Free Survival
  • Graft vs Host Disease / mortality
  • Graft vs Host Disease / prevention & control*
  • Hodgkin Disease* / mortality
  • Hodgkin Disease* / prevention & control
  • Humans
  • Leukemia* / mortality
  • Leukemia* / prevention & control
  • Living Donors
  • Lymphocyte Transfusion*
  • Middle Aged
  • Recurrence
  • Survival Rate
  • Time Factors

Substances

  • Antimetabolites, Antineoplastic
  • Azacitidine