Modified Donor Lymphocyte Infusion after HLA-Mismatched/Haploidentical T Cell-replete Hematopoietic Stem Cell Transplantation for Prophylaxis of Relapse of Leukemia in Patients with Advanced Leukemia

摘要

We evaluated the safety and efficacy of donor lymphocyte infusion (DLI) with granulocyte colony-stimulating factor priming and short-term immunosuppressive agents for prophylaxis of relapse in patients with advanced leukemia after human leukocyte antigen (HLA)-mismatched T cell-replete hematopoietic stem cell transplantation (HCT). Twenty-nine patients received prophylactic DLI at a median 75 (33–120) days after HCT. Acute graft-vs-host disease (GVHD) grades 3–4 occurred in six patients, and all cases were controlled. Eleven patients were alive and relapse-free with a probability of leukemia-free survival (LFS) of 37.3 ± 9.6% at 3 years. Chronic GVHD was associated with a lower relapse rate and higher probability of LFS. Prophylactic-modified DLI is feasible in patients with advanced leukemia to prevent relapse after HLA-mismatched HCT.