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Donor Lymphocytes

Myeloablative T cell-depleted alloSCT with early sequential prophylactic donor lymphocyte infusion is an efficient and safe post-remission treatment for adult ALL

Bone Marrow Transplantation volume 49, pages 287–291 (2014)Cite this article

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A Corrigendum to this article was published on 05 February 2014

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Abstract

The prognosis of adult patients with ALL remains unsatisfactory. AlloSCT is associated with a beneficial GVL response mediated by donor T cells. However, GVHD results in substantial mortality and long-term morbidity. T-cell depletion (TCD) of the graft reduces the severity of GVHD, but is associated with an increased relapse rate after alloSCT. Therefore, early sequential donor lymphocyte infusion (DLI) is likely to be necessary for a successful GVL reaction. Twenty-five adult ALL patients (10 Ph+ALL) were eligible for early DLI after initial disease control with myeloablative TCD-alloSCT in first CR (CR1), if active GVHD was absent at 3–6 months after alloSCT. Patients with a sibling donor or an unrelated donor were scheduled for 3.0 × 106 CD3+ cells/kg or 1.5 × 106 CD3+ cells/kg, respectively, at 6 months after alloSCT. Three patients died before evaluation (one early relapse). Five patients had active GVHD. Fourteen of the remaining seventeen patients received DLI (median time-to-DLI: 185 days). Overall, only 17% required long-term systemic immunosuppression for GVHD. With a median follow-up after TCD-alloSCT of 50 months, 2-year survival probability was 68% (95% confidence interval (CI) 49–87%). In conclusion, myeloablative TCD-alloSCT with early sequential DLI is an efficient and safe post-remission treatment for adult ALL patients in CR1.

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  • 05 February 2014

    This article has been corrected since Online Publication and a corrigendum has also been published.

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Acknowledgements

This work was supported by research grant 2008-4263 from the Dutch Cancer Society, Amsterdam, The Netherlands.

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Authors and Affiliations

  1. Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands

    M Eefting, C J M Halkes, C M van Pelt, S Kersting, E W A Marijt, P A von dem Borne, R Willemze, H Veelken & J H F Falkenburg

  2. Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands

    L C de Wreede

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  1. M Eefting
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Correspondence to J H F Falkenburg.

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Eefting, M., Halkes, C., de Wreede, L. et al. Myeloablative T cell-depleted alloSCT with early sequential prophylactic donor lymphocyte infusion is an efficient and safe post-remission treatment for adult ALL. Bone Marrow Transplant 49, 287–291 (2014). https://doi.org/10.1038/bmt.2013.111

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