1. ¹Service d'Hématologie Clinique, Hôpital Edouard Herriot, Lyon cedex, France
2. ²Laboratoire d'histocompatibilité, Etablissement Français du Sang, Lyon, France
3. ³Laboratoire d'Hématologie, Hôpital Edouard Herriot, Lyon cedex, France
4. ⁴Banque de cellules et de tissus, Etablissement Français du Sang, Hôpital Edouard Herriot, Lyon cedex, France

Correspondence: Dr A-S Michallet, Service d'Hématologie Clinique Adultes, Hôpital Edouard Herriot, 5 Place d'Arsonval, 69347 Lyon cedex 03, France. E-mail: annesophie.michallet@voila.fr

Received 22 April 2004; Accepted 25 September 2004; Published online 31 January 2005.

Abstract

In order to study efficacy, toxicity and the long-term results of donor lymphocyte infusions (DLI), we retrospectively analyzed DLI given for relapse after conventional allogeneic hematopoietic stem cell transplantation (HSCT) in 30 patients with a median delay of 107.5 months after transplant and 58 months after DLI. After DLI, 15 patients established full donor chimerism, three patients developed grade III and one grade IV acute GVHD. A total of 15 patients achieved a disease response. Among the 14 patients with chronic myeloid leukemia (CML), 11 are alive at the last follow-up: five are in complete molecular response (CMR) and two in complete cytogenetic response (CCR) with no other intervention after DLI, three in CMR after imatinib mesylate given after DLI and one in complete hematological response after imatinib mesylate and reduced-intensity conditioning allogeneic SCT performed after DLI. At the time of the last follow-up, 19 (63%) patients died and 11 (37%) remain alive. The 3-year probability of survival for the entire population, CML patients and non-CML patients, was 60, 93, 62% after transplantation, and 48, 80 and 48% after DLI, respectively. A multivariate analysis demonstrated a significantly worse survival rate after transplantation for female recipients, advanced disease and acute leukemia before transplantation.