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Post-Transplant Events

Response and toxicity of donor lymphocyte infusions following T-cell depleted non-myeloablative allogeneic hematopoietic SCT from 3–6/6 HLA matched donors

Bone Marrow Transplantation volume 43, pages 327–333 (2009)Cite this article

Abstract

We report the outcome of early donor lymphocyte infusions (DLIs) after T-cell depleted non-myeloablative transplantation using stem cells from HLA-matched or mismatched donors. Sixty-nine patients with high-risk hematologic malignancies received DLI following fludarabine, CY and alemtuzumab with infusion of stem cells from a matched sibling (52) or partially matched family member donor (17). Patients received the first infusion at a median of 50 days after transplant, and doses ranged from 1 × 104 CD3+ cells/kg to 3.27 × 108 CD3+ cells/kg, depending on clinical status and the physician's discretion. A median cell dose of 1 × 105 CD3+ cells/kg in the mismatched setting and 1 × 106 CD3+ cells/kg in the matched sibling setting appears safe with only 1 of 7 (14%) and 4 of 31 patients (13%), respectively, experiencing severe acute GVHD at these doses. Importantly, 38% of patients with persistent disease before DLI attained a remission after infusion. Nine of the 69 patients remain alive and disease-free 32–71 months after the first DLI. In conclusion, low doses of DLI can be safely provided soon after T-cell depleted non-myeloablative therapy and provide a chance of remission. However, long-term survival still remains poor, primarily because of relapse in these patients.

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Authors and Affiliations

  1. Division of Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, NC, USA

    D A Rizzieri, P Dev, G D Long, C Gasparetto, K M Sullivan, Ml Horwitz, J Chute & N J Chao

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  1. D A Rizzieri
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  2. P Dev
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  3. G D Long
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  4. C Gasparetto
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Correspondence to D A Rizzieri.

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Rizzieri, D., Dev, P., Long, G. et al. Response and toxicity of donor lymphocyte infusions following T-cell depleted non-myeloablative allogeneic hematopoietic SCT from 3–6/6 HLA matched donors. Bone Marrow Transplant 43, 327–333 (2009). https://doi.org/10.1038/bmt.2008.321

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