Donor Lymphocyte Infusion Is a Feasible Way to Improve Survival in Patients with Acute Myeloid Leukemia and Myelodysplastic Syndromes Who Relapse after Allogeneic Stem Cell Transplantation.

Autor:	Minculescu L; Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Reekie J; Department of Infectious Diseases, PERSIMUNE, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Petersen SL; Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Kornblit BT; Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Schjoedt I; Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Andersen NS; Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Andersen LP; Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Fischer-Nielsen A; Department of Quality, StemMedical A/S, Soeborg, Denmark., Haastrup EK; Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Friis LS; Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Sengelov H; Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Jazyk:	angličtina
Zdroj:	Acta haematologica [Acta Haematol] 2024; Vol. 147 (3), pp. 325-332. Date of Electronic Publication: 2023 Oct 12.
DOI:	10.1159/000534315
Abstrakt:	Introduction: Donor lymphocyte infusion (DLI) is used to induce remission in patients who relapse after allogeneic stem cell transplantation (allo-HSCT). During the last decade, the hypomethylating agent Azacitidine has been used together with DLI for a synergistic graft-versus-leukemia (GVL) effect. Here, we report results of DLI/Azacitidine treatment from a retrospective single-center study. Methods: Fifty AML/MDS patients treated for relapse after allo-HSCT between 2001 and 2020 with DLI at the Department of Hematology, at Rigshospitalet, Copenhagen University Hospital were included for analyses. A subgroup of patients who obtained complete remission (CR) after reinduction chemotherapy, received DLI in combination with low-dose (32 mg/m2) Azacitidine. Results: Overall survival in all patients after DLI treatment was 59% at 2 years and 20% at 5 years. Relapse-free survival in patients in CR prior to DLI was 32% after 2 years and 7% after 5 years. In the DLI + low-dose-Azacitidine group, 5-year relapse-free survival was 40%. Conclusion: DLI remains an effective treatment in post-transplant relapse leaving one-fifth of patients' long-term survivors. Our results support the concomitant use of low-dose Azacitidine in the future use of DLI in order to enhance the GVL effect of donor lymphocytes. (© 2023 S. Karger AG, Basel.)
Databáze:	MEDLINE
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