Donor CD3+ lymphocyte infusion after reduced intensity conditioning allogeneic stem cell transplantation: Single-center experience

Jean El-Cheikh, Roberto Crocchiolo, Sabine Furst, Patrick Ladaique, Luca Castagna, Catherine Faucher, Boris Calmels, Claire Oudin, Claude Lemarie, Angela Granata, Raynier Devillier, Norbert Vey, Reda Bouabdallah, Christian Chabannon, Didier Blaise

Research output: Contribution to journalArticle

Abstract

Donor lymphocyte infusions (DLI) can induce remission in patients with hematologic malignancies who relapse after allogeneic stem cell transplantation. However, graft-vs-host disease (GVHD) remains a major complication of this strategy. We have used escalating doses of DLI for many years, and wanted to assess the risk factors for GVHD and transplant-related mortality as well as disease outcomes according to the reason for DLI. We analyzed 65 patients who received a total of 111 DLI for different reasons and at different intervals after transplantation. Median number of DLI was 2 (range, 1-4), median interval between transplantation and DLI was 9 months (range, 1-41 months) and median number of infused CD3+ cells/kg recipient body weight was 2.5 × 107 (range, 1 × 106-11.8 × 107). Reasons for DLI were relapse or progression in 37 patients (57%), residual disease in 15 patients (23%), and persistence of mixed chimerism in 13 patients (20%). Seven patients (11%) developed acute GVHD grade II to IV and 5 patients (8%) developed extensive chronic GVHD. In univariate analysis, we could identify a transplantation-DLI interval ≤6 months, the dose of DLI (≥1 × 107), and DLI number as predictive factors of GVHD. In multivariate analysis, these results were confirmed only for the transplantation-DLI interval (hazard ratio = 19.48; 2.23-170.34; p = 0.007). Our findings indicate that this form of adoptive immunotherapy is well tolerated and induces a low incidence of GVHD and transplant-related mortality, supporting further investigation as an upfront modality to enhance the graft-vs-tumor response in high-risk patients.

Original languageEnglish
Pages (from-to)17-27
Number of pages11
JournalExperimental Hematology
Volume41
Issue number1
DOIs
Publication statusPublished - Jan 2013

ASJC Scopus subject areas

  • Cancer Research
  • Cell Biology
  • Genetics
  • Molecular Biology
  • Hematology

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    El-Cheikh, J., Crocchiolo, R., Furst, S., Ladaique, P., Castagna, L., Faucher, C., Calmels, B., Oudin, C., Lemarie, C., Granata, A., Devillier, R., Vey, N., Bouabdallah, R., Chabannon, C., & Blaise, D. (2013). Donor CD3+ lymphocyte infusion after reduced intensity conditioning allogeneic stem cell transplantation: Single-center experience. Experimental Hematology, 41(1), 17-27. https://doi.org/10.1016/j.exphem.2012.09.008