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Donor Lymphocyte Infusions

Individually adjusted prophylactic donor lymphocyte infusions after CD34-selected allogeneic peripheral blood stem cell transplantation

Bone Marrow Transplantation volume 28, pages 963–968 (2001)Cite this article

Abstract

T cell depletion of the graft increases graft failure and relapse rate in allogeneic PBSC transplantation. Delayed lymphocyte add-back after T cell-depleted transplants might prevent these complications. We present 22 consecutive allogeneic PBSC transplants from related histocompatible donors with positive selection of CD34+ cells. Recipients received prophylactic donor lymphocyte infusions (DLI) depending on their risk of relapse and of developing GVHD. Patients were considered at high risk of relapse with AML > first CR, ALL > second CR, and CML in accelerated or blastic phase. Patients were considered at high risk of developing GVHD if older than 35 years, or with a donor sensitized through previous pregnancy or blood transfusion. Patients at high risk of relapse and low risk of GVHD were scheduled to receive three DLI. Patients at low risk of relapse and high risk of GVHD did not receive DLI. The remaining patients were scheduled to receive two DLI. The DLI were administered on days +28 (2 × 105/kg), +60 (2 × 105/kg) and +90 (2 × 106/kg) after transplant. G-CSF mobilized peripheral stem cells from healthy donors were positively selected by an immunomagnetic method. The mean CD34+ cells and CD3+ cells infused were 4.4 × 106(range 1.9–10.6) and 0.085 × 105 (range 0.01–0.67). Cyclosporin A was given to prevent GVHD. All the patients engrafted. Twenty-two prophylactic DLI were performed in 12 patients: seven developed acute GVHD (one case grade III–IV) and none presented pancytopenia. At a mean follow-up of 585 days (range 89–1103), 14 patients were alive in CR, one patient was alive in relapse, four patients had died of relapse and three had died of transplant-related complication. Individually adjusted prophylactic DLI at the doses we used with an escalating schedule allowed an acceptable GVHD rate and a good engraftment of donor hematopoiesis. Bone Marrow Transplantation (2001) 28, 963–968.

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Acknowledgements

This work was supported by the Fundación Internacional José Carreras para la Lucha contra la Leucemia FIJC/AG00. MRL is a recipient of a grant BEFI 99/9136 from the Spanish Health Ministry.

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Authors and Affiliations

  1. Hematology Department, Institut Català d'Oncologia>, Duran i Reynals Hospital, Barcelona, Spain

    C Ferrá, M Rodríguez-Luaces, D Gallardo, M Encuentra, J Peris, I Ancín, J Sarrá, JJ Berlanga & A Grañena

  2. Cryobiology and Cell Therapy Department, Institut de Recerca Oncològica, Duran i Reynals Hospital, Barcelona, Spain

    GA Martín-Henao & J García

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Ferrá, C., Rodríguez-Luaces, M., Gallardo, D. et al. Individually adjusted prophylactic donor lymphocyte infusions after CD34-selected allogeneic peripheral blood stem cell transplantation. Bone Marrow Transplant 28, 963–968 (2001). https://doi.org/10.1038/sj.bmt.1703277

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