Clinical and immunologic outcomes following haplocompatible donor lymphocyte infusions

• Published in: Bone marrow transplantation (Basingstoke) Vol. 44; no. 12; pp. 805 - 812
• Main Authors: Dvorak, C C, Gilman, A L, Horn, B, Jaroscak, J, Dunn, E A, Baxter-Lowe, L A, Cowan, M J
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.12.2009; Nature Publishing Group
• Subjects: Acute Disease; Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Donors; Bone marrow, stem cells transplantation. Graft versus host reaction; Cell Biology; Child; Child, Preschool; Chronic Disease; Confidence intervals; Cytomegalovirus; Cytomegalovirus - immunology; Cytomegalovirus Infections - immunology; Cytomegalovirus Infections - mortality; Disease-Free Survival; Female; Graft vs Host Disease - blood; Graft vs Host Disease - immunology; Graft vs Host Disease - mortality; Graft-versus-host reaction; Granulocyte colony-stimulating factor; Haplotypes; Health aspects; Hematologic Neoplasms - blood; Hematologic Neoplasms - immunology; Hematologic Neoplasms - mortality; Hematologic Neoplasms - therapy; Hematology; Hematopoietic Stem Cell Transplantation; Hematopoietic stem cells; Humans; Immune response; Infant; Infection; Infections; Internal Medicine; Lymphocyte Transfusion; Lymphocytes; Lymphocytes T; Male; Medical sciences; Medicine; Medicine & Public Health; original-article; Patients; Pediatrics; Physiological aspects; Prevention; Public Health; Recovery of Function - immunology; Retrospective Studies; Risk factors; Severe Combined Immunodeficiency - blood; Severe Combined Immunodeficiency - immunology; Severe Combined Immunodeficiency - mortality; Severe Combined Immunodeficiency - therapy; Stem cell transplantation; Stem Cells; Survival Rate; Time Factors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation, Homologous; United States; hematopoietic SCT; donor lymphocyte infusions; haplocompatible; Prognosis; Treatment; Donor; Hematology; Donor lymphocyte infusion; Immunotherapy; Adoptive immunization; Lymphocyte; Hematopoietic stem cell transplantation
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2009.87

We retrospectively analyzed the characteristics of 16 consecutive pediatric patients who received one or more G-CSF-mobilized donor lymphocyte infusions (DLI) following a T-cell-depleted haplocompatible hematopoietic SCT (HSCT) to enhance immune recovery and/or treat an infection. The median time from HSCT to administration of first DLI was 12 weeks and the median dose of DLI administered was 3 × 10 4 /kg (range, 2.5–6 × 10 4 /kg). The incidence of Grade I–II acute GVHD was 19% (95% confidence interval (CI), 6–44%), and there were no cases of Grade III–IV acute GVHD. Chronic GVHD developed in 13% (95% CI, 2–37%) of patients. In surviving patients who did not undergo a second stem cell infusion, T-cell numbers and function increased to a protective level in a median of 3 months (range, 2–12.5 months) following the first DLI administration. In patients given DLI for treatment of an infection, 75% (95% CI, 46–92%) cleared their infection after a median of 9 weeks (range, 1–27 weeks). In patients with CMV infection, the development of CMV-specific T cells was observed following DLI. The 1-year overall survival following haplocompatible DLI was 71% (95% CI, 59–83%), with a median follow-up of 16 months from the first DLI.