Donor lymphocyte infusion for relapsed hematological malignancies after allogeneic hematopoietic cell transplantation: Prognostic relevance of the initial CD3+ T cell dose

Merav Bar, Brenda M. Sandmaier, Yoshihiro Inamoto, Benedetto Bruno, Parameswaran Hari, Thomas Chauncey, Paul J. Martin, Rainer Storb, David G. Maloney, Barry Storer, Mary E.D. Flowers

Research output: Contribution to journalArticlepeer-review

78 Citations (Scopus)

Abstract

The impact of donor lymphocyte infusion (DLI) initial cell dose on its outcome is known in patients with chronic myeloid leukemia but limited in patients with other hematological malignancies. In this retrospective study, we evaluated the effect of initial DLI CD3+ cell dose on graft-versus-host disease (GVHD) and overall survival after DLI given for relapse of any hematological malignancies after allogeneic hematopoietic cell transplantation (HCT) with high- or reduced-intensity conditioning. The cohort included 225 patients. Initial DLI CD3+ cell dose per kilogram of recipient body weight was ≤1 × 107 (n = 84; group A), >1.0 to <10 × 107 (n = 58; group B), and ≥10 × 107 (n = 66; group C). The initial cell dose was unknown for the remaining 17 patients. Cumulative incidence rates of GVHD at 12 months after DLI were 21%, 45%, and 55% for groups A, B, and C, respectively. Multivariate analysis showed that initial DLI CD3+ cell ≥10 × 107 dose per kilogram is associated with an increased risk of GVHD after DLI (P = .03). Moreover, an initial DLI CD3+ cell dose of 10 × 107 or higher did not decrease the risk of relapse and did not improve overall survival. Thus, these results support the use of less than 10 × 107 CD3+ cell per kilogram as the initial cell dose of DLI for treatment of persistent or recurrent hematological malignancy after HCT.

Original languageEnglish
Pages (from-to)949-957
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume19
Issue number6
DOIs
Publication statusPublished - 06-2013
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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