A Retrospective Comparison of DLI and gDLI for Post-Transplant Treatment.
Sylvain LamureFranciane PaulAnne-Laure GagezJérémy DelageLaure VincentNathalie FegueuxAnne SirventEve GehlkopfJean Luc VeyruneLu Zhao YangTarik KanouniValère CacheuxJérôme MoreauxBeatrice BonafouxGuillaume CartronJohn De VosPatrice CeballosPublished in: Journal of clinical medicine (2020)
Donor lymphocyte infusion (DLI) is used to prevent or treat haematological malignancies relapse after allogeneic stem cell transplantation (allo-SCT). Recombinant human granulocyte colony-stimulated factor primed DLI (gDLI) is derived from frozen aliquots of the peripheral blood stem cell collection. We compared the efficacy and safety of gDLI and classical DLI after allo-SCT. We excluded haploidentical allo-SCT. Initial diseases were acute myeloblastic leukaemia (n = 45), myeloma (n = 38), acute lymphoblastic leukaemia (n = 20), non-Hodgkin lymphoma (n = 10), myelodysplasia (n = 8), Hodgkin lymphoma (n = 8), chronic lymphocytic leukaemia (n = 7), chronic myeloid leukaemia (n = 2) and osteomyelofibrosis (n = 1). Indications for DLI were relapse (n = 96) or pre-emptive treatment (n = 43). Sixty-eight patients had classical DLI and 71 had gDLI. The response rate was 38.2%, the 5-year progression-free survival (PFS) rate was 38% (29-48) and the 5-year overall survival (OS) rate was 37% (29-47). Graft versus host disease rate was 46.7% and 10.1% of patients died from toxicity. There were no differences between classical DLI and gDLI in terms of response (p = 0.28), 5-year PFS (p = 0.90), 5-year OS (p. 0.50), GvHD (p = 0.86), treated GvHD (p = 0.81) and cause of mortality (p. 0.14). In conclusion, this study points out no major effectiveness or toxicity of gDLI compared to classical DLI.
Keyphrases
- stem cell transplantation
- peripheral blood
- free survival
- newly diagnosed
- end stage renal disease
- stem cells
- high dose
- chronic kidney disease
- hodgkin lymphoma
- ejection fraction
- bone marrow
- recombinant human
- liver failure
- prognostic factors
- systematic review
- type diabetes
- drug induced
- oxidative stress
- respiratory failure
- acute myeloid leukemia
- intensive care unit
- coronary artery disease
- cardiovascular events
- cardiovascular disease
- risk factors
- acute lymphoblastic leukemia
- combination therapy
- patient reported outcomes
- allogeneic hematopoietic stem cell transplantation
- replacement therapy
- patient reported