Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population

J. E. Levine, A. J. Barrett, M. J. Zhang, M. Arora, M. A. Pulsipher, N. Bunin, J. Fort, F. Loberiza, D. Porter, S. Giralt, W. Drobyski, D. Wang, S. Pavletic, O. Ringden, M. M. Horowitz, R. Collins

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

Donor leukocyte infusions (DLI) can reverse relapse of hematologic malignancy following allogeneic hematopoietic stem cell transplant (HSCT) in some cases. Little is known regarding the effectiveness of DLI in children who relapse after HSCT. We report outcomes of 49 children who received DLI for relapse after allogeneic transplant. Prognosis was particularly poor (0/14 responses) for patients relapsing within 6 months from transplant. DLI rarely induced remission when given as sole therapy for marrow relapse. One-year disease-free survival was 30% (6/20) in patients who received DLI as consolidation following chemotherapy. The development of GVHD grades 1-2 was associated with superior 3-year survival than patients who developed GVHD grades 3-4 (P<0.002). To determine the benefit of DLI, 45 children who received DLI for relapse (four children without matches were excluded) were compared to 1229 children with similar characteristics whose relapse was not treated with DLI. There was no difference in survival (P=0.30) once adjustments were made to account for the time from relapse to DLI. Although a few children achieved durable remissions when DLI was used as part of a post-relapse treatment strategy, DLI was unsuccessful in the majority of cases. Strategies may be better directed at preempting post transplant relapse.

Original languageEnglish (US)
Pages (from-to)201-205
Number of pages5
JournalBone Marrow Transplantation
Volume42
Issue number3
DOIs
StatePublished - Jul 22 2008

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Levine, J. E., Barrett, A. J., Zhang, M. J., Arora, M., Pulsipher, M. A., Bunin, N., Fort, J., Loberiza, F., Porter, D., Giralt, S., Drobyski, W., Wang, D., Pavletic, S., Ringden, O., Horowitz, M. M., & Collins, R. (2008). Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population. Bone Marrow Transplantation, 42(3), 201-205. https://doi.org/10.1038/bmt.2008.135