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Graft-Versus-Tumor Effects

Escalating-dose HLA-mismatched DLI is safe for the treatment of leukaemia relapse following alemtuzumab-based myeloablative allo-SCT

Bone Marrow Transplantation volume 48, pages 1324–1328 (2013)Cite this article

Abstract

Although the feasibility of using HLA-mismatched unrelated donors as an alternate graft source for haematopoietic SCT (HSCT) has been shown, little is known about the safety of HLA-mismatched DLI for the treatment of relapse. We examined the outcome of 58 consecutive leukaemia patients who received escalating-dose DLI for treatment of relapse after alemtuzumab-conditioned myeloablative unrelated donor HSCT at our institution. High-resolution HLA typing on stored DNA samples revealed mismatches in 28/58 patients who were considered HLA-matched at the time of transplantation. Following DLI from HLA-matched (10/10) (n=30) or -mismatched (7-9/10) (n=28) unrelated donors, we found no significant difference in the incidence of acute GVHD (17.2% versus 23.1%, P=0.59), probability of remission at 3 years (62.1% versus 63.9%, P=0.89) or 5-year OS (89.8% versus 77.7%, P=0.22). We conclude that escalating-dose DLI can be safely given to HLA-mismatched recipients following T-depleted myeloablative HSCT.

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Acknowledgements

This work was supported by Leuka (registered charity number 286231) and the National Institute for Health Research (NIHR) Biomedical Research Centre.

Author’s contribution

AI performed data collection, analysed the data and wrote the paper; RB performed research and analysed the data; RS provided reagents and analysed the data; GD analysed the data and contributed to writing the paper; LF and EB provided sample material and contributed to the paper; DM and SM analysed the data and contributed to writing the paper, D, MM, EK, JP, AR, IR, JG, JA and FD provided patient care, and contributed to writing of the paper; RS analysed the data and wrote the paper; KR designed and supervised the research, analysed the data and wrote the paper.

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Authors and Affiliations

  1. Centre for Haematology, Faculty of Medicine, Imperial College London, London, UK

    A J Innes, G Damaj, L Foroni, D Marin, E Kanfer, D Milojkovic, D MacDonald, J Pavlu, A Rahemtulla, I Roberts, J Goldman, J Apperley, R Szydlo, F Dazzi & K Rezvani

  2. Department of Immunology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK

    R Beattie & R Sergeant

  3. Department of Internal Medicine II, Allogeneic Blood Stem Cell Transplant Section, University of Wuerzburg Medical Center, Wuerzburg, Germany

    S Mielke

  4. Department of Haematology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK

    D Slade & E Bray

  5. Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, TX, USA

    K Rezvani

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  1. A J Innes
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  2. R Beattie
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  11. J Pavlu
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  16. J Goldman
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Corresponding author

Correspondence to K Rezvani.

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Competing interests

Dr John Goldman is Editor in Chief of Bone Marrow Transplantation. The remaining authors declare no conflict of interest.

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Innes, A., Beattie, R., Sergeant, R. et al. Escalating-dose HLA-mismatched DLI is safe for the treatment of leukaemia relapse following alemtuzumab-based myeloablative allo-SCT. Bone Marrow Transplant 48, 1324–1328 (2013). https://doi.org/10.1038/bmt.2013.69

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