Donor lymphocyte infusion after allogeneic haematopoietic cell transplantation for haematological malignancies: basic considerations and best practice recommendations from the EBMT.

Since the early description of three patients with relapsed leukaemia after allogeneic haematopoietic cell transplantation (HCT) who obtained complete remission after donor lymphocyte infusions (DLIs), the added value of this procedure to induce or maintain graft-versus-leukaemia immunity has been undisputed. For more than 30 years, DLIs have become common practice as prophylactic, pre-emptive, or therapeutic immunotherapy. However, as with many aspects of allogeneic HCT, centres have developed their own routines and practices, and many questions related to the optimal applications and toxicity, or to the immunobiology of DLI induced tumour-immunity, remain. As a part of the Practice Harmonization and Guidelines Committee and the Cellular Therapy and Immunobiology Working Party of the European Society for Blood and Marrow Transplantation effort, a panel of experts with clinical and translational knowledge in transplantation immunology and cellular therapy met during a 2-day workshop in September, 2023, in Lille, France, and developed a set of consensus-based recommendations for the application of unmanipulated DLI after allogeneic HCT for haematological malignancies. Given the absence of prospective data in the majority of publications, these recommendations are mostly based on retrospective studies and expert consensus.
Competing Interests: Declaration of interests SP has received travel expenses or honoraria for participation in advisory boards, symposia, or other scientific events from Alexion, Novartis, Jazz Pharmaceutical, Therakos, OneLamda, and Sobi; and received research funding from Janssen Horizon. CS has received travel expenses or honoraria for participation in advisory boards, symposia, or other scientific events from Novartis, Jazz Pharmaceutical, Neovii, Janssen, and Kite Pharma. JK has received grants from Novartis, Miltenyi Biotech, and Gadeta; is a Gadeta shareholder; and holds patent licenses with Gadeta and Miltenyi Biotech. All other authors declare no competing interests.
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