Efficacy of donor lymphocyte infusion in patients after different types of allogeneic hematopoietic stem cell transplantation

O.A. Slesarchuk

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. akad. I.P. Pavlova

E.V. Babenko

Institut detskoĭ onkologii, gematologii i transplantologii im. R.M. Gorbachevoĭ, SPbGMU im. akad. I.P. Pavlova

E.V. Semenova

B.V. Petrovsky Russian Research Center of Surgery ,Department of Acquired Heart Valvular Diseases, Moscow, Russia

S.N. Bondarenko

Institut detskoĭ onkologii, gematologii i transplantologii im. R.M. Gorbachevoĭ, SPbGMU im. akad. I.P. Pavlova

M.A. Éstrina

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. akad. I.P. Pavlova

E.V. Morozova

Otdelenie rentgenokhirurgicheskikh metodov diagnostiki i lecheniia FGBU "FTs SSKh" Minzdravsotsrazvitiia Rossii, Penza

O.V. Paina

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. akad. I.P. Pavlova

V.N. Vavilov

Institut detskoĭ onkologii, gematologii i transplantologii im. R.M. Gorbachevoĭ, SPbGMU im. akad. I.P. Pavlova

B.I. Smirnov

Sankt-Peterburgskiĭ gosudarstvennyĭ élektrotekhnicheskiĭ universitet im. V.I. Ul'ianova

L.S. Zubarovskaia

Klinika "Institut detskoĭ gematologii i transplantologii im. R.M. Gorbachevoĭ" Sankt-Peterburgskogo gosudarstvennogo meditsinskogo universiteta im. I.P. Pavlova

B.V. Afanas'ev

Klinika "Institut detskoĭ gematologii i transplantologii im. R.M. Gorbachevoĭ" Sankt-Peterburgskogo gosudarstvennogo meditsinskogo universiteta im. I.P. Pavlova

Efficacy of donor lymphocyte infusion in patients after different types of allogeneic hematopoietic stem cell transplantation

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O.A. Slesarchuk, E.V. Babenko, E.V. Semenova, S.N. Bondarenko, M.A. Éstrina, E.V. Morozova, O.V. Paina, V.N. Vavilov, B.I. Smirnov, L.S. Zubarovskaia, B.V. Afanas'ev

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Journal: Therapeutic Archive. 2013;85(7): 26‑33

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Slesarchuk OA, Babenko EV, Semenova EV, Bondarenko SN, Éstrina MA, Morozova EV, Paina OV, Vavilov VN, Smirnov BI, Zubarovskaia LS, Afanas'ev BV. Efficacy of donor lymphocyte infusion in patients after different types of allogeneic hematopoietic stem cell transplantation. Therapeutic Archive. 2013;85(7):26‑33. (In Russ.)

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Aim. To evaluate the efficacy of donor lymphocyte infusion (DLI) to prevent and treat recurrences in patients after different types of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Subjects and methods. Data from 118 patients with malignant blood diseases were analyzed. Allo-HSCTs from HLA-matched related donors (n=49), HLA-matched unrelated donors (n=50), partially HLA-matched unrelated donors (n=2), and haploidentical donors (n=24) were performed. The indications for DLI were underlying disease relapse (59 DLIs), resistant disease course (n=40), minimal residual disease (n=16), falling donor chimerism (n=15), and recurrence prevention (n=13). Results. Therapy response was obtained after 57 (44%) DLIs. There were 36 (25%) and 30 (21%) cases of acute and chronic graft-versus-host reactions (GVHR), respectively. The use of DLI from HLA-matched donors, its performance in the periods of D+100 to one year after allo-HSCT, a donor chimerism level of over 90% at the moment of DLI, the administration of the initial DLI dose of below 1·106 CD3+/kg, and the development of chronic GVHR after DLI were associated with the highest rate of therapy responses. The overall survival rates of patients with DLI were significantly influenced by factors, such as DLI periods, donor chimerism levels at DLI, and the development of chronic GVHR after DLI. Conclusion. The choice of the optimal dose of cells, the periods of DLI and its preventive administration improve prognosis in patients after allo-HSCT. The occurrence of acute GVHR is affected by the degree of HLA matching and the type of a donor. The development of chronic GVHR after DLI is associated with the highest rate of responses to DLI and higher survival rates.

Keywords:

allogeneic hematopoietic stem cell transplantation

underlying disease relapse

donor lymphocyte infusion

Authors:

O.A. Slesarchuk

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. akad. I.P. Pavlova

E.V. Babenko

Institut detskoĭ onkologii, gematologii i transplantologii im. R.M. Gorbachevoĭ, SPbGMU im. akad. I.P. Pavlova

E.V. Semenova

B.V. Petrovsky Russian Research Center of Surgery ,Department of Acquired Heart Valvular Diseases, Moscow, Russia

S.N. Bondarenko

Institut detskoĭ onkologii, gematologii i transplantologii im. R.M. Gorbachevoĭ, SPbGMU im. akad. I.P. Pavlova

M.A. Éstrina

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. akad. I.P. Pavlova

E.V. Morozova

Otdelenie rentgenokhirurgicheskikh metodov diagnostiki i lecheniia FGBU "FTs SSKh" Minzdravsotsrazvitiia Rossii, Penza

O.V. Paina

Sankt-Peterburgskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. akad. I.P. Pavlova

V.N. Vavilov

Institut detskoĭ onkologii, gematologii i transplantologii im. R.M. Gorbachevoĭ, SPbGMU im. akad. I.P. Pavlova

B.I. Smirnov

Sankt-Peterburgskiĭ gosudarstvennyĭ élektrotekhnicheskiĭ universitet im. V.I. Ul'ianova

L.S. Zubarovskaia

Klinika "Institut detskoĭ gematologii i transplantologii im. R.M. Gorbachevoĭ" Sankt-Peterburgskogo gosudarstvennogo meditsinskogo universiteta im. I.P. Pavlova

B.V. Afanas'ev

Klinika "Institut detskoĭ gematologii i transplantologii im. R.M. Gorbachevoĭ" Sankt-Peterburgskogo gosudarstvennogo meditsinskogo universiteta im. I.P. Pavlova

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