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DLI after haploidentical BMT with post-transplant CY.

Authors :
Ghiso A
Raiola AM
Gualandi F
Dominietto A
Varaldo R
Van Lint MT
Bregante S
Di Grazia C
Lamparelli T
Galaverna F
Stasia A
Luchetti S
Geroldi S
Grasso R
Colombo N
Bacigalupo A
Source :
Bone marrow transplantation [Bone Marrow Transplant] 2015 Jan; Vol. 50 (1), pp. 56-61. Date of Electronic Publication: 2014 Oct 13.
Publication Year :
2015

Abstract

Forty-two patients relapsing after an unmanipulated haploidentical BM transplant and post-transplant CY (PT-CY), were given 108 DLI, with median interval from transplant of 266 days (range, 67-1372). DLI were given at escalating doses, expressed as CD3+ cells/kg, without GVHD prophylaxis, and ranged from 1 × 10(3) to 1 × 10(7) cells/kg (median 5 × 10(5) cells/kg). The average number of DLI per patient was 2.6 (range, 1-6). The diagnosis was leukemias (n=32) grafted with a myeloablative regimen and Hodgkin's disease (n=10), grafted with a nonmyeloablative regimen. Leukemic patients with molecular relapse (n=20), received DLI alone (n=17) or in association with azacytidine (n=3); leukemic patients with hematologic relapse (n=12) received chemotherapy followed by DLI (n=11) or DLI alone (n=1); Hodgkin patients received DLI following 1-3 courses of chemotherapy. In these three groups the incidence of acute GVHD II-III was 15%, 17% and 10%; response rate was 45%, 33% and 70%; 2-year actuarial survival was 43%, 19% and 80% respectively. This study confirms that escalating doses of DLI can be given in the haploidentical setting with PT-CY, with a relatively low risk of acute GVHD. Response rates and survival are dependent on the underlying disease.

Details

Language :
English
ISSN :
1476-5365
Volume :
50
Issue :
1
Database :
MEDLINE
Journal :
Bone marrow transplantation
Publication Type :
Academic Journal
Accession number :
25310304
Full Text :
https://doi.org/10.1038/bmt.2014.217