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Donor lymphocyte infusions after haploidentical stem cell transplantation with PTCY: A study on behalf of the EBMT cellular therapy & immunobiology working party

Bone Marrow Transplantation volume 58, pages 54–60 (2023)Cite this article

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Abstract

Donor lymphocyte infusion (DLI) is a treatment option to prevent or treat relapse after allogeneic hematopoietic cell transplantation (HCT). We here report data for 173 patients who received one or multiple DLIs after haploidentical-HCT with post-transplant cyclophosphamide (PTCY) at 47 EBMT centers from 2009 to 2018. Indication for DLI was: prophylactic for 59 (34.3%), preemptive for 20(11.6%), and therapeutic for 93(54.1%). For the prophylactic group, the median number of DLIs was 1 (IQR:1–2.5) with a median first dose of 0.1 × 106 CD3+ T cell/kg, for the preemptive 2 (IQR:1–3) with 0.5 × 106 CD3+ T cell/kg, for the therapeutic 1 (IQR:1–3) with 1 × 106CD3+ Tcell/kg, respectively. OS after first DLI was 61% (46–75%) for prophylactic, 40% (19–61%) for preemptive, and 22% (13–31%) for therapeutic. CI of II-IV aGVHD and cGVHD was 17% (7–27%) and 53% (40–67%) for the prophylactic, 20% (2–38%) and 21% (3–39%) for the preemptive, 17% (9–24%) and 24% (15–33%) for the therapeutic group, respectively. Our data show great variability in the indications and modalities of DLI across responding EBMT centers. Survival rates remain relatively low in patients with active disease. While the cumulative incidence of aGVHD appears acceptable, we showed a high incidence of cGVHD in the prophylactic group, compared with preemptive and therapeutic DLI. These data should be investigated further in prospective clinical trials.

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The final analysis dataset will be available upon specific request to the Working Party chair.

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Acknowledgements

We thank the clinical staff and investigators of the EBMT centers involved in this research and especially thank the patients who participated in the study.

Author information

Authors and Affiliations

  1. Department of Hematology and Oncology, Ospedale Civile “Santo Spirito”, Pescara, Italy

    Nicole Santoro & Mauro Di Ianni

  2. EBMT Statistical Unit, Leiden, The Netherlands

    Jarl E. Mooyaart

  3. Institut Paoli-Calmettes, Centre de Lutte Contre le Cancer, & Centre de Recherches en Cancérologie de Marseille (CRCM), Inserm UMR 1068, Université d’Aix-Marseille, Marseille, France

    Raynier Devillier

  4. Medicana International Hospital Istanbul, Istanbul, Turkey

    Yener Koc

  5. Institute of Hematology and Blood Transfusion, Prague, Czech Republic

    Jan Vydra

  6. Istituto Clinico Humanitas, Milano, Italy

    Luca Castagna

  7. Anadolu Medical Center Hospital, Kocaeli, Turkey

    Zafer Gülbas

  8. Servicio de Hematología Hospital G. Universitario Gregorio Marañon, Instituto de Investigación sanitaria Gregorio Marañon, Department of Medicine Universidad Complutense, Madrid, Spain

    José Diez Martin

  9. Hospital U. Marqués de Valdecilla, Santander, Spain

    Mercedes Colorado Araujo

  10. RM Gorbacheva Research Institute, Pavlov University, St, Petersburg, Russia

    Alexander Kulagin

  11. Demiroglu Bilim University Istanbul Florence Nightingale Hospital Istanbul, Istanbul, Turkey

    Mutlu Arat

  12. Hospital Universitario Reina Sofia. IMIBIC. University of Cordoba, Cordoba, Spain

    Concepcion Herrera Arroyo

  13. Institute of Hematology, Centro Ricerche Emato-Oncologiche, Ospedale S. Maria della Misericordia, University of Perugia, Perugia, Italy

    Maria Paola Martelli

  14. EBMT Leiden Study Unit, Leiden, The Netherlands

    Jorinde D. Hoogenboom

  15. Leiden University Medical Center, Leiden, The Netherlands

    Liesbeth C. de Wreede

  16. San Raffaele Scientific Institute, Hematology and Bone marrow Transplantation unit, Milan, Italy

    Annalisa Ruggeri

  17. Institut Paoli-Calmettes, Centre de Lutte Contre le Cancer & Centre d’Investigations Cliniques en Biothérapie, Université d’Aix-Marseille, Inserm CBT, 1409, Marseille, France

    Christian Chabannon

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Contributions

AR and CC designed the study, NS and AR wrote the manuscript, JEM, and LCdW performed the statistical analysis, JDH prepared the data, DB, YC, JV, LC, ZG, JDM, MCA, AK, MA, CHA provided cases for the study, MPM and MDI helped in data interpretation. All authors edited and approved the manuscript.

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Correspondence to Nicole Santoro.

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The original online version of this article was revised: The color coding for our three subsets of patients were not identical in Figure 1 and Figure 2. While the “therapeutic” subset appears in green in both figures, the “pre-emptive” group appears in blue in Figure 1 and in red in Figure 2. Conversely, the “prophylactic” group appears in red in Figure 1, and in blue in Figure 2. The order the three groups appear in the legend is also different. This presentation may be confusing to future readers, and thus we would like to substitute a new version of this two figures where the sole modification is harmonization of the color coding, and of the order in entries in the legend.

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Santoro, N., Mooyaart, J.E., Devillier, R. et al. Donor lymphocyte infusions after haploidentical stem cell transplantation with PTCY: A study on behalf of the EBMT cellular therapy & immunobiology working party. Bone Marrow Transplant 58, 54–60 (2023). https://doi.org/10.1038/s41409-022-01839-8

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