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Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population. Bone Marrow Transplant 2008 Aug;42(3):201-5 PMID: 18490913

Pubmed ID

18490913

Abstract

Donor leukocyte infusions (DLI) can reverse relapse of hematologic malignancy following allogeneic hematopoietic stem cell transplant (HSCT) in some cases. Little is known regarding the effectiveness of DLI in children who relapse after HSCT. We report outcomes of 49 children who received DLI for relapse after allogeneic transplant. Prognosis was particularly poor (0/14 responses) for patients relapsing within 6 months from transplant. DLI rarely induced remission when given as sole therapy for marrow relapse. One-year disease-free survival was 30% (6/20) in patients who received DLI as consolidation following chemotherapy. The development of GVHD grades 1-2 was associated with superior 3-year survival than patients who developed GVHD grades 3-4 (P<0.002). To determine the benefit of DLI, 45 children who received DLI for relapse (four children without matches were excluded) were compared to 1229 children with similar characteristics whose relapse was not treated with DLI. There was no difference in survival (P=0.30) once adjustments were made to account for the time from relapse to DLI. Although a few children achieved durable remissions when DLI was used as part of a post-relapse treatment strategy, DLI was unsuccessful in the majority of cases. Strategies may be better directed at preempting post transplant relapse.

Author List

Levine JE, Barrett AJ, Zhang MJ, Arora M, Pulsipher MA, Bunin N, Fort J, Loberiza F, Porter D, Giralt S, Drobyski W, Wang D, Pavletic S, Ringden O, Horowitz MM, Collins R Jr

Authors

William R. Drobyski MD Professor in the Medicine department at Medical College of Wisconsin
Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-50049106424   36 Citations

MESH terms used to index this publication - Major topics in bold

Acute Disease
Child
Combined Modality Therapy
Disease-Free Survival
Female
Graft vs Host Disease
Graft vs Tumor Effect
Hematologic Neoplasms
Humans
Leukemia
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Leukocyte Transfusion
Male
Recurrence
Stem Cell Transplantation
Tissue Donors
Transplantation, Homologous
jenkins-FCD Prod-300 626508253d14e4184314fb9f66322a03a5906796