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Graft-versus-tumor Effects

Prevention of relapse using granulocyte CSF-primed PBPCs following HLA-mismatched/haploidentical, T-cell-replete hematopoietic SCT in patients with advanced-stage acute leukemia: a retrospective risk-factor analysis

Bone Marrow Transplantation volume 47, pages 1099–1104 (2012)Cite this article

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Abstract

The role of donor lymphocyte infusion (DLI) in the prophylaxis of relapse has not been defined. We retrospectively analyzed the data from 88 patients with advanced-stage acute leukemia after HLA-mismatched/haploidentical hematopoietic SCT (HSCT) whose treatment did (n=61) or did not (n=27) include granulocyte CSF (GCSF)-primed PBPCs infusion (GPBPCI). The two groups were compared with respect to relapse and OS. Further, a detailed analysis of risk factors was performed. The 2-year cumulative incidence of relapse in patients receiving prophylactic GPBPCI and not receiving prophylactic GPBPCI were 36% and 55% (P=0.017), respectively. Estimated survival at 3 years was 31% for patients receiving prophylactic GPBPCI and 11% for patients not receiving prophylactic GPBPCI (P=0.001). The three-year probability of leukemia-free survival was also higher in patients who received prophylactic GPBPCI (22%) compared with patients who did not (11%) (P=0.003). Multivariate analysis for relapse showed that use of prophylactic GPBPCI after transplantation was an independent prognostic factor (P=0.025). Higher OS was associated with use of prophylactic GPBPCI (P=0.002), AML (P=0.027) and female sex (P=0.023). Our results suggest that use of prophylactic GPBPCI may increase survival of patients with advanced-stage acute leukemia who receive HLA-mismatched/haploidentical HSCT.

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Acknowledgements

This work was supported (in part) by National Natural Science Foundation of China (grant No. 30971292), National High-tech R&D Program of China (863 Program), Leading Program of Clinical Faculty accredited by the Ministry of Health of China, National Scientific Major Program-major new drug formulation (grant No. 2008zx09312-026) and Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation. We thank American Journal Experts for reviewing the paper in English. We thank every faculty member who has participated in these studies.

Author contributions: Conception and design: Huang Xiao-Jun; analysis and interpretation of the data: Huang Xiao-Jun and Wang-Yu; drafting of the article: Huang Xiao-Jun and Wang-Yu; final approval of the article: all authors; provision of study materials or patients: all authors; obtaining of funding: Huang Xiao-Jun; administrative, technical, or logistic support: Huang Xiao-Jun and Liu Kai-Yan; collection and assembly of data: Wang-Yu.

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  1. Peking University People's Hospital, Institute of Hematology, Beijing, China

    Y Wang, D-H Liu, L-P Xu, K-Y Liu, H Chen, X-H Zhang, Y-H Chen, W Han, F-R Wang, J-Z Wang, C-H Yan & X-J Huang

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  1. Y Wang
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Correspondence to X-J Huang.

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Wang, Y., Liu, DH., Xu, LP. et al. Prevention of relapse using granulocyte CSF-primed PBPCs following HLA-mismatched/haploidentical, T-cell-replete hematopoietic SCT in patients with advanced-stage acute leukemia: a retrospective risk-factor analysis. Bone Marrow Transplant 47, 1099–1104 (2012). https://doi.org/10.1038/bmt.2011.213

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