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Donor Lymphocyte Infusions

Factors predicting response and graft-versus-host disease after donor lymphocyte infusions: a study on 593 infusions

Bone Marrow Transplantation volume 31, pages 687–693 (2003)Cite this article

Summary:

In the present study, we analyze factors predicting graft-versus-host disease (GvHD) and response after donor lymphocyte infusions (DLI). A total of 100 patients received 593 DLI between June 1990 and December 2000 in a bulk dose (n=14) or in escalating dose infusions (n=86). Patients were analyzed after stratification for type of relapse: (1) molecular relapse (n=6), (2) cytogenetic relapse (n=20), (3) chronic phase of chronic myeloid leukemia (CML) or complete remission of other disease post chemotherapy (n=24), (4) CML in accele-rated/blastic phase (n=14), (5) resistant disease not responding to chemotherapy (n=36). The proportion of responders to DLI in these five groups was 100, 90, 75, 36 and 0% (P<0.0001). Factors predicting response by multivariate analysis were type of relapse (P<0.0001), post-DLI GvHD (P=0.005), pancytopenia (P=0.008), and a diagnosis of CML (P=0.04). Acute GvHD (grades II—IV) occurred in 21 patients (21%), and correlated in multivariate analysis with pancytopenia and less than four DLI. Other predictors of GvHD were the number of CD3+cells/infusion and serum levels of gamma-glutamyl transferase (γGT). The actuarial probability of treatment-related mortality was 9% for HLA identical siblings and 44% for alternative donor transplants (P=0.006). Response to DLI is predicted by tumor burden and is associated with GvHD and pancytopenia.

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Acknowledgements

This work was supported by Associazione Italiana Ricerca contro il Cancro (AIRC) Milano grant to AB and Associazione Ricerca Trapianto Midollo Osseo (ARITMO) Genova. The great work of our nursing staff is gratefully acknowledged.

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  1. Dipartimento di Emato-Oncologia, e Centro Trasfusionale, Ospedale San Martino, Genova, Italy

    A M Raiola, M T Van Lint, M Valbonesi, T Lamparelli, F Gualandi, D Occhini, S Bregante, C di Grazia, A Dominietto, M Soracco, C Romagnani, F Vassallo, M Casini, B Bruno, F Frassoni & A Bacigalupo

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Raiola, A., Van Lint, M., Valbonesi, M. et al. Factors predicting response and graft-versus-host disease after donor lymphocyte infusions: a study on 593 infusions. Bone Marrow Transplant 31, 687–693 (2003). https://doi.org/10.1038/sj.bmt.1703883

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