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- Title
Response and toxicity of donor lymphocyte infusions following T-cell depleted non-myeloablative allogeneic hematopoietic SCT from 3–6/6 HLA matched donors.
- Authors
Rizzieri, D. A.; Dev, P.; Long, G. D.; Gasparetto, C.; Sullivan, K. M.; Horwitz, M. l.; Chute, J.; Chao, N. J.
- Abstract
We report the outcome of early donor lymphocyte infusions (DLIs) after T-cell depleted non-myeloablative transplantation using stem cells from HLA-matched or mismatched donors. Sixty-nine patients with high-risk hematologic malignancies received DLI following fludarabine, CY and alemtuzumab with infusion of stem cells from a matched sibling (52) or partially matched family member donor (17). Patients received the first infusion at a median of 50 days after transplant, and doses ranged from 1 × 104 CD3+ cells/kg to 3.27 × 108 CD3+ cells/kg, depending on clinical status and the physician's discretion. A median cell dose of 1 × 105 CD3+ cells/kg in the mismatched setting and 1 × 106 CD3+ cells/kg in the matched sibling setting appears safe with only 1 of 7 (14%) and 4 of 31 patients (13%), respectively, experiencing severe acute GVHD at these doses. Importantly, 38% of patients with persistent disease before DLI attained a remission after infusion. Nine of the 69 patients remain alive and disease-free 32–71 months after the first DLI. In conclusion, low doses of DLI can be safely provided soon after T-cell depleted non-myeloablative therapy and provide a chance of remission. However, long-term survival still remains poor, primarily because of relapse in these patients.Bone Marrow Transplantation (2009) 43, 327–333; doi:10.1038/bmt.2008.321; published online 13 October 2008
- Subjects
TOXICITY testing; STEM cell transplantation; LEUKEMIA; LYMPHOMAS; HOMOGRAFTS
- Publication
Bone Marrow Transplantation, 2009, Vol 43, Issue 4, p327
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/bmt.2008.321