Superiority of preemptive donor lymphocyte infusion based on minimal residual disease in acute leukemia patients after allogeneic hematopoietic stem cell transplantation

Tan, Yamin; Du, Kaili; Luo, Yi; Shi, Jimin; Cao, Ling; Zheng, Yunquan; Zheng, Gaofeng; Zhao, Yanmin; Ye, Xiujing; Zhang, Cai; Huang, He

doi:10.1111/trf.12524

Cited by 33 publications

(24 citation statements)

References 35 publications

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“…The number of patients was limited in the MRD group; nevertheless, observation of high effectiveness and low toxicity of DLI in patients with persistent residual disease is well confirmed. [24][25][26] The time of DLI infusion for NA and RIC indications was similar, and showed a small divergence in individual cases in comparison with the application time for MRD and REL indications. In the former case, this time was determined by the approximate course of HSCT and engraftment, whereas, in the latter, such a large dispersion was caused by the variability of disease nature after HSCT.…”

Section: Discussionmentioning

confidence: 94%

Adoptive therapy with donor lymphocyte infusion after allogenic hematopoietic SCT in pediatric patients

Goździk

Rewucka

Krasowska-Kwiecień

et al. 2014

Bone Marrow Transplant

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The aim of this study was to analyse the experience of Polish Pediatric Group for Hematopoietic Stem Cell Transplantation in respect to donor lymphocyte infusion procedure. The study included 51 pediatric patients with malignant (45) and non-malignant (6) diseases treated with DLI in the period 1993-2012. The indications for DLI were as follows: (1) increasing recipient chimerism after non-ablative hematopoietic SCT (18 patients); (2) immunomodulation after a reduced intensity conditioning regimen (2 patients); (3) increase in minimal residual disease detection (3 patients); and (4) relapse (28 patients). DLI was carried out at a median of 6 (0.5-79) months after SCT. DLI was administered as either a single-dose (in 19 cases) or in escalating-dose regimens (in 32 cases). The median total dose of CD3-positive T cells was 28.0 (0.1-730.0) × 10 6 /kg body weight. The time for assessment of DLI efficacy ranged from 0 to 70 (median 3) months. At evaluation, 18 patients experienced CR, 3 achieved PR, 19 showed relapse and 11 rejected the graft. DLI was found to be effective in 39% of cases. Complications of the procedure occurred in 18 patients; of these, 2 died. To sum up DLI shows efficacy in a significant percentage of children. Mortality related to the therapy adverse effects is low. However, this method requires standardization.

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Section: Discussionmentioning

confidence: 94%

Adoptive therapy with donor lymphocyte infusion after allogenic hematopoietic SCT in pediatric patients

Goździk

Rewucka

Krasowska-Kwiecień

et al. 2014

Bone Marrow Transplant

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“…Various modifications of DLI have been investigated, such as ex vivo activated DLI and earlier introduction of DLI [24][25][26]. A recent report [26] showed that preemptive DLI given when minimal residual disease (MRD) was detected effectively reverted MRD back to remission in all 16 treated patients with acute leukemia and offered long-term survival in 15 of the 16 patients without increasing the risk of GVHD development. Thus, early detection of potential disease progression by detecting MRD and subsequently performing DLI before overt relapse might be a better way to improve the success of HSCT for AML.…”

Section: Discussionmentioning

confidence: 99%

Donor Lymphocyte Infusion for the Treatment of Relapsed Acute Myeloid Leukemia after Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Analysis by the Adult Acute Myeloid Leukemia Working Group of the Japan Society for Hematopoietic Cell Transplantation

Takami

Yano

Yokoyama

et al. 2014

Biology of Blood and Marrow Transplantation

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Because the efficacy of donor lymphocyte infusion (DLI) for acute myeloid leukemia (AML) relapse after allogeneic hematopoietic stem cell transplantation (HSCT) remains uncertain, especially in the Asian population, a nationwide registry study was retrospectively performed by the Adult AML Working Group of the Japan Society for Hematopoietic Cell Transplantation to identify the factors affecting the patient survival after DLI. Among 143 adult AML patients who received DLI for the treatment of first hematological relapse after HSCT, the overall survival rates at 1 year, 2 years, and 5 years were 32% ± 4%, 17% ± 3%, and 7% ± 3%, respectively. Complete remission (CR) at the time of DLI, which was obtained in 8% of the patients, was the strongest predictive factor for survival after DLI. Therefore, long-term survival after DLI was achieved almost exclusively in patients who successfully achieved a CR before DLI, indicating the limited efficacy of DLI in a minority of patients.

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“…[5] DLI as a leukemia control strategy may be particularly effective when employed preemptively upon detection of disease recurrence by minimal residual disease (MRD) but before frank relapse. [6] We report the case of a now 9-year-old female with multiple recurrent T-ALL for whom second haplo-BMT and successive haplo-DLIs are providing persistent (currently 3 years 5 months posttransplant) disease control with minimal side effects and excellent quality of life.…”

Section: Introductionmentioning

confidence: 99%

“…The enhanced GVL conferred by establishment of a haploidentical graft further makes possible subsequent use of haploidentical donor lymphocyte infusions (haplo‐DLIs) as a disease control strategy with acceptable toxicities . DLI as a leukemia control strategy may be particularly effective when employed preemptively upon detection of disease recurrence by minimal residual disease (MRD) but before frank relapse …”

Section: Introductionmentioning

confidence: 99%

Persistent Multiyear Control of Relapsed T‐Cell Acute Lymphoblastic Leukemia With Successive Donor Lymphocyte Infusions: A Case Report

Huo

Symons

Robey

et al. 2016

Pediatric Blood & Cancer

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There are few therapeutic options for patients with T-ALL who have recurrent disease after initial matched sibling hematopoietic stem cell transplantation. While a second HSCT from a haploidentical donor offers the conceptual possibility of greater graft-vs-leukemia effect, there is minimal literature to describe the efficacy of this approach in recurrent pediatric T-ALL. We present the case of a now 9 year old girl in whom second haploidentical HSCT, followed by successive donor lymphocyte infusions (DLI) in response to minimal residual disease (MRD) reemergence, has led to three-plus years of ongoing disease control without GVHD and excellent quality of life.

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Superiority of preemptive donor lymphocyte infusion based on minimal residual disease in acute leukemia patients after allogeneic hematopoietic stem cell transplantation

Abstract: Our results demonstrated the efficacy and safety of pDLI and suggested that pDLI based on MRD monitoring was superior in acute leukemia patients with potential progression compared with salvage DLI administrated in overt relapse.

Cited by 33 publications

References 35 publications

Adoptive therapy with donor lymphocyte infusion after allogenic hematopoietic SCT in pediatric patients

Adoptive therapy with donor lymphocyte infusion after allogenic hematopoietic SCT in pediatric patients

Donor Lymphocyte Infusion for the Treatment of Relapsed Acute Myeloid Leukemia after Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Analysis by the Adult Acute Myeloid Leukemia Working Group of the Japan Society for Hematopoietic Cell Transplantation

Persistent Multiyear Control of Relapsed T‐Cell Acute Lymphoblastic Leukemia With Successive Donor Lymphocyte Infusions: A Case Report

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