DLI after haploidentical BMT with post-transplant CY

A Ghiso, AM Raiola, F Gualandi, A Dominietto… - Bone marrow …, 2015 - nature.com
A Ghiso, AM Raiola, F Gualandi, A Dominietto, R Varaldo, MT Van Lint, S Bregante…
Bone marrow transplantation, 2015nature.com
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 …
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.
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