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Graft-Versus-Tumor Effects

Clinical and immunologic outcomes following haplocompatible donor lymphocyte infusions

Bone Marrow Transplantation volume 44, pages 805–812 (2009)Cite this article

Abstract

We retrospectively analyzed the characteristics of 16 consecutive pediatric patients who received one or more G-CSF-mobilized donor lymphocyte infusions (DLI) following a T-cell-depleted haplocompatible hematopoietic SCT (HSCT) to enhance immune recovery and/or treat an infection. The median time from HSCT to administration of first DLI was 12 weeks and the median dose of DLI administered was 3 × 104/kg (range, 2.5–6 × 104/kg). The incidence of Grade I–II acute GVHD was 19% (95% confidence interval (CI), 6–44%), and there were no cases of Grade III–IV acute GVHD. Chronic GVHD developed in 13% (95% CI, 2–37%) of patients. In surviving patients who did not undergo a second stem cell infusion, T-cell numbers and function increased to a protective level in a median of 3 months (range, 2–12.5 months) following the first DLI administration. In patients given DLI for treatment of an infection, 75% (95% CI, 46–92%) cleared their infection after a median of 9 weeks (range, 1–27 weeks). In patients with CMV infection, the development of CMV-specific T cells was observed following DLI. The 1-year overall survival following haplocompatible DLI was 71% (95% CI, 59–83%), with a median follow-up of 16 months from the first DLI.

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Acknowledgements

We thank the medical, nursing and stem cell laboratory staff of the Bone Marrow Transplant Units at the UCSF Children's Hospital and the UNC Children's Hospital who provided dedicated care to the patients in this report.

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Authors and Affiliations

  1. Division of Pediatric Blood and Marrow Transplant, UCSF Children's Hospital, University of California, San Francisco, CA, USA

    C C Dvorak, B Horn, E A Dunn & M J Cowan

  2. Division of Pediatric Blood and Marrow Transplantation, Levine Children's Hospital, Charlotte, NC, USA

    A L Gilman

  3. Division of Pediatric Hematology/Oncology, University of North Carolina, Chapel Hill, NC, USA

    J Jaroscak

  4. Department of Surgery, University of California, San Francisco, CA, USA

    L A Baxter-Lowe

Authors
  1. C C Dvorak
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  2. A L Gilman
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  3. B Horn
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  4. J Jaroscak
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  5. E A Dunn
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  6. L A Baxter-Lowe
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  7. M J Cowan
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Correspondence to C C Dvorak.

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Dvorak, C., Gilman, A., Horn, B. et al. Clinical and immunologic outcomes following haplocompatible donor lymphocyte infusions. Bone Marrow Transplant 44, 805–812 (2009). https://doi.org/10.1038/bmt.2009.87

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