¹Department of Haematology, Nottingham City Hospital, Nottingham, UK

Correspondence: Dr EP Das-Gupta, Department of Haematology, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. E-mail: emma.das-gupta@nottingham.ac.uk

Received 4 February 2005; Accepted 28 April 2005; Published online 27 June 2005.

Abstract

We treated 17 patients with refractory (n=7) or relapsed lymphoid malignancy (n=10) following allogeneic HSCT with donor lymphocyte infusions (DLI). Patients with low-grade disease received DLI alone (n=7) or following radiotherapy (n=1). Patients with aggressive disease (n=9) received prior chemotherapy. Nine out of 15 patients receiving DLI from sibling donors responded after one (n=6), two (n=2) and three (n=1) infusions. Both MUD recipients achieved CR after two and three DLI. In all, 10/17 patients achieved CR including 3/4 patients with chronic lymphatic leukaemia (CLL), 4/4 with mantle cell lymphoma (MCL), 3/4 with follicular NHL but 0/5 with aggressive NHL/Richters. The median CD3 cell dose to achieve CR for siblings was 2 10⁷/kg. One patient with CLL had a second transplant following DLI-induced aplasia and is in CR at 14 months giving a final CR rate of 64%. Grade II–IV acute GVHD developed in 45% and chronic GVHD in 8/9 evaluable patients. Of the 11 patients finally achieving CR, one patient with MCL relapsed at 18 months post-DLI but all others remain in remission with a median follow-up of 40 months (range 12–64 months). Low-grade NHL and MCL have a high response rate and sustained remissions following DLI. Aggressive disease responds poorly however, despite pre-DLI chemotherapy.