Long-term Results of Adjuvant Donor Lymphocyte Transfusion in AML After Allogeneic Stem Cell Transplantation

Overview

Journal Bone Marrow Transplant

Specialty General Surgery

Date 2015 Oct 6

PMID 26437060

Citations 43

Authors

Z Jedlickova

C Schmid

C Koenecke

B Hertenstein

H Baurmann

R Schwerdtfeger

J Tischer

H-J Kolb

M Schleuning

Affiliations

Soon will be listed here.

Abstract

Adjuvant transfusion of donor lymphocytes (aDLT) may reduce the risk of relapse after allogeneic stem cell transplantation in high-risk AML. We performed a retrospective analysis on the safety and efficacy of aDLT in a cohort of 46 patients. To be eligible for aDLT, patients had to be in CR for at least 120 days from transplantation, off immunosuppression for ⩾30 days and free of GvHD. Thirty-four patients with similar disease characteristics and fulfilling the same selection criteria served as controls. Median follow-up among aDLT recipients was 7.2 years. Ten patients (22%) relapsed inspite of aDLT, as compared with 53% in the control group. Induction of GvHD was the main complication. However, non-relapse mortality was low with patients dying from infection (n=2), severe chronic GvHD (n=1) and secondary malignancy (n=2). At the time of analysis, 31/46 aDLT recipients were alive in CR at a median of 5.7 years after first aDLT. Overall survival at 7 years after transplant was 67% as compared with 31% in the control group (P<0.001). In conclusion, aDLT is safe, when given in escalating doses to a well predefined group of patients. Long-term survival can be achieved.

Citing Articles

HLA evolutionary divergence score after donor lymphocyte infusion following allogeneic hematopoietic stem cell transplantation.

Le Grand S, Villemonteix J, Daguindau E, Fort M, Caillat-Zucman S, Allain V Hemasphere. 2025; 9(2):e70088.

PMID: 39949376 PMC: 11822263. DOI: 10.1002/hem3.70088.

Maintenance Therapy Post-Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia.

Canichella M, Molica M, Mazzone C, de Fabritiis P Curr Oncol. 2024; 31(10):6050-6060.

PMID: 39451755 PMC: 11506619. DOI: 10.3390/curroncol31100451.

Modified Prophylactic Donor Lymphocyte Infusion (DLI) in an Adult T Cell Lymphoma/Leukemia (ATLL) Patient-Modality of Relapse Prevention.

Ionete A, Bardas A, Varady Z, Vasilica M, Szegedi O, Coriu D Diseases. 2024; 12(9).

PMID: 39329879 PMC: 11431229. DOI: 10.3390/diseases12090210.

Cell-Based Treatment in Acute Myeloid Leukemia Relapsed after Allogeneic Stem Cell Transplantation.

Canichella M, de Fabritiis P Biomedicines. 2024; 12(8).

PMID: 39200186 PMC: 11351713. DOI: 10.3390/biomedicines12081721.

Post-Transplant Maintenance Therapy in Acute Myeloid Leukemia.

Parks K, Aslam M, Kumar V, Jamy O Cancers (Basel). 2024; 16(11).

PMID: 38893135 PMC: 11171221. DOI: 10.3390/cancers16112015.

References

Collins Jr R, Shpilberg O, Drobyski W, Porter D, Giralt S, Champlin R . Donor leukocyte infusions in 140 patients with relapsed malignancy after allogeneic bone marrow transplantation. J Clin Oncol. 1997; 15(2):433-44. DOI: 10.1200/JCO.1997.15.2.433. View

Rettinger E, Willasch A, Kreyenberg H, Borkhardt A, Holter W, Kremens B . Preemptive immunotherapy in childhood acute myeloid leukemia for patients showing evidence of mixed chimerism after allogeneic stem cell transplantation. Blood. 2011; 118(20):5681-8. DOI: 10.1182/blood-2011-04-348805. View

Liga M, Triantafyllou E, Tiniakou M, Lambropoulou P, Karakantza M, Zoumbos N . High alloreactivity of low-dose prophylactic donor lymphocyte infusion in patients with acute leukemia undergoing allogeneic hematopoietic cell transplantation with an alemtuzumab-containing conditioning regimen. Biol Blood Marrow Transplant. 2012; 19(1):75-81. DOI: 10.1016/j.bbmt.2012.07.021. View

Roddie C, Peggs K . Donor lymphocyte infusion following allogeneic hematopoietic stem cell transplantation. Expert Opin Biol Ther. 2011; 11(4):473-87. DOI: 10.1517/14712598.2011.554811. View

Mrozek K, Marcucci G, Nicolet D, Maharry K, Becker H, Whitman S . Prognostic significance of the European LeukemiaNet standardized system for reporting cytogenetic and molecular alterations in adults with acute myeloid leukemia. J Clin Oncol. 2012; 30(36):4515-23. PMC: 3518729. DOI: 10.1200/JCO.2012.43.4738. View

Rosenow F, Berkemeier A, Krug U, Muller-Tidow C, Gerss J, Silling G . CD34(+) lineage specific donor cell chimerism for the diagnosis and treatment of impending relapse of AML or myelodysplastic syndrome after allo-SCT. Bone Marrow Transplant. 2013; 48(8):1070-6. DOI: 10.1038/bmt.2013.2. View

Loren A, Porter D . Donor leukocyte infusions for the treatment of relapsed acute leukemia after allogeneic stem cell transplantation. Bone Marrow Transplant. 2007; 41(5):483-93. DOI: 10.1038/sj.bmt.1705898. View

Krishnamurthy P, Potter V, Barber L, Kulasekararaj A, Lim Z, Pearce R . Outcome of donor lymphocyte infusion after T cell-depleted allogeneic hematopoietic stem cell transplantation for acute myelogenous leukemia and myelodysplastic syndromes. Biol Blood Marrow Transplant. 2012; 19(4):562-8. DOI: 10.1016/j.bbmt.2012.12.013. View

Dey B, McAfee S, Colby C, Sackstein R, Saidman S, Tarbell N . Impact of prophylactic donor leukocyte infusions on mixed chimerism, graft-versus-host disease, and antitumor response in patients with advanced hematologic malignancies treated with nonmyeloablative conditioning and allogeneic bone marrow.... Biol Blood Marrow Transplant. 2003; 9(5):320-9. DOI: 10.1016/s1083-8791(03)00077-6. View

10.

Schmid C, Schleuning M, Ledderose G, Tischer J, Kolb H . Sequential regimen of chemotherapy, reduced-intensity conditioning for allogeneic stem-cell transplantation, and prophylactic donor lymphocyte transfusion in high-risk acute myeloid leukemia and myelodysplastic syndrome. J Clin Oncol. 2005; 23(24):5675-87. DOI: 10.1200/JCO.2005.07.061. View

11.

Mackinnon S, Papadopoulos E, Carabasi M, Reich L, Collins N, Boulad F . Adoptive immunotherapy evaluating escalating doses of donor leukocytes for relapse of chronic myeloid leukemia after bone marrow transplantation: separation of graft-versus-leukemia responses from graft-versus-host disease. Blood. 1995; 86(4):1261-8. View

12.

Baron F, Labopin M, Niederwieser D, Vigouroux S, Cornelissen J, Malm C . Impact of graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantation for acute myeloid leukemia: a report from the Acute Leukemia Working Party of the European group for blood and marrow transplantation. Leukemia. 2012; 26(12):2462-8. DOI: 10.1038/leu.2012.135. View

13.

. Allogeneic peripheral blood stem-cell compared with bone marrow transplantation in the management of hematologic malignancies: an individual patient data meta-analysis of nine randomized trials. J Clin Oncol. 2005; 23(22):5074-87. PMC: 1475795. DOI: 10.1200/JCO.2005.09.020. View

14.

Bethge W, Hegenbart U, Stuart M, Storer B, Maris M, Flowers M . Adoptive immunotherapy with donor lymphocyte infusions after allogeneic hematopoietic cell transplantation following nonmyeloablative conditioning. Blood. 2003; 103(3):790-5. DOI: 10.1182/blood-2003-07-2344. View

15.

Molldrem J, Lee P, Wang C, Felio K, Kantarjian H, Champlin R . Evidence that specific T lymphocytes may participate in the elimination of chronic myelogenous leukemia. Nat Med. 2000; 6(9):1018-23. DOI: 10.1038/79526. View

16.

Faber L, Veenhof W, Willemze R, Falkenburg J . Generation of CD4+ cytotoxic T-lymphocyte clones from a patient with severe graft-versus-host disease after allogeneic bone marrow transplantation: implications for graft-versus-leukemia reactivity. Blood. 1995; 86(7):2821-8. View

17.

Schleuning M . Adoptive allogeneic immunotherapy--history and future perspectives. Transfus Sci. 2000; 23(2):133-50. DOI: 10.1016/s0955-3886(00)00078-3. View

18.

Marks D, Lush R, Cavenagh J, Milligan D, Schey S, Parker A . The toxicity and efficacy of donor lymphocyte infusions given after reduced-intensity conditioning allogeneic stem cell transplantation. Blood. 2002; 100(9):3108-14. DOI: 10.1182/blood-2002-02-0506. View

19.

de Lima M, Bonamino M, Vasconcelos Z, Colares M, Diamond H, Zalcberg I . Prophylactic donor lymphocyte infusions after moderately ablative chemotherapy and stem cell transplantation for hematological malignancies: high remission rate among poor prognosis patients at the expense of graft-versus-host disease. Bone Marrow Transplant. 2001; 27(1):73-8. DOI: 10.1038/sj.bmt.1702726. View

20.

Massenkeil G, Nagy M, Lawang M, Rosen O, Genvresse I, Geserick G . Reduced intensity conditioning and prophylactic DLI can cure patients with high-risk acute leukaemias if complete donor chimerism can be achieved. Bone Marrow Transplant. 2003; 31(5):339-45. DOI: 10.1038/sj.bmt.1703859. View