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Cellular Therapy

Donor-lymphocyte infusion following haploidentical hematopoietic cell transplantation with peripheral blood stem cell grafts and PTCy

Bone Marrow Transplantation volume 52, pages 1623–1628 (2017)Cite this article

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Abstract

Donor-lymphocyte infusion (DLI) for relapse following haploidentical hematopoietic cell transplantation (haploHCT) with post-transplant cyclophosphamide (PTCy) has been described in recipients of bone marrow grafts, but not recipients of G-CSF mobilized peripheral blood (PB) grafts. We retrospectively identified patients who underwent DLI following PB-haploHCT with PTCy for relapse, or loss of chimerism (LOC). Twelve patients (57%) received DLI for hematologic relapse/persistent disease, seven (33%) for extramedullary relapse and two (10%) for LOC. Sixteen (76%) received chemotherapy prior to DLI, which did not correlate with response. The most common first dose was 1 × 106 CD3+ cells/kg. Two patients developed grade I aGvHD post DLI, one had grade II and two had grade III. One developed mild skin cGvHD 1361 days post DLI. Pre-DLI aGvHD predicted post-DLI aGvHD (P=0.025). Six patients achieved CR after DLI for overt relapse, one achieved full donor chimerism after LOC. Patients with LOC or EM relapse had superior relapse-free survival following DLI (P=0.029). DLI following PB-haploHCT with PTCy is a viable salvage therapy for overt relapse or LOC without a substantial increase in GvHD, and donor lymphocytes may be collected simultaneously with graft collection to facilitate availability in patients at high risk of relapse.

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Acknowledgements

Research reported in this publication was supported by the Washington University Institute of Clinical and Translational Sciences Grant UL1TR000448, sub-award TL1TR000449, from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH.

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  1. S R Goldsmith and M Slade: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine, Bone Marrow Transplantation and Leukemia Program, Washington University School of Medicine, St. Louis, MO, USA

    S R Goldsmith, M Slade, J F DiPersio, P Westervelt, M A Schroeder & R Romee

  2. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA

    F Gao

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  1. S R Goldsmith
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  2. M Slade
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Correspondence to R Romee.

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Goldsmith, S., Slade, M., DiPersio, J. et al. Donor-lymphocyte infusion following haploidentical hematopoietic cell transplantation with peripheral blood stem cell grafts and PTCy. Bone Marrow Transplant 52, 1623–1628 (2017). https://doi.org/10.1038/bmt.2017.193

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