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Response and toxicity of donor lymphocyte infusions following T-cell depleted non-myeloablative allogeneic hematopoietic SCT from 3-6/6 HLA matched donors.

Publication ,  Journal Article
Rizzieri, DA; Dev, P; Long, GD; Gasparetto, C; Sullivan, KM; Horwitz, M; Chute, J; Chao, NJ
Published in: Bone Marrow Transplant
February 2009

We report the outcome of early donor lymphocyte infusions (DLIs) after T-cell depleted non-myeloablative transplantation using stem cells from HLA-matched or mismatched donors. Sixty-nine patients with high-risk hematologic malignancies received DLI following fludarabine, CY and alemtuzumab with infusion of stem cells from a matched sibling (52) or partially matched family member donor (17). Patients received the first infusion at a median of 50 days after transplant, and doses ranged from 1 x 10(4) CD3+ cells/kg to 3.27 x 10(8) CD3+ cells/kg, depending on clinical status and the physician's discretion. A median cell dose of 1 x 10(5) CD3+ cells/kg in the mismatched setting and 1 x 10(6) CD3+ cells/kg in the matched sibling setting appears safe with only 1 of 7 (14%) and 4 of 31 patients (13%), respectively, experiencing severe acute GVHD at these doses. Importantly, 38% of patients with persistent disease before DLI attained a remission after infusion. Nine of the 69 patients remain alive and disease-free 32-71 months after the first DLI. In conclusion, low doses of DLI can be safely provided soon after T-cell depleted non-myeloablative therapy and provide a chance of remission. However, long-term survival still remains poor, primarily because of relapse in these patients.

Duke Scholars

Published In

Bone Marrow Transplant

DOI

EISSN

1476-5365

Publication Date

February 2009

Volume

43

Issue

4

Start / End Page

327 / 333

Location

England

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Transplantation Conditioning
  • Tissue Donors
  • T-Lymphocytes
  • Survivors
  • Prospective Studies
  • Myeloablative Agonists
  • Middle Aged
  • Lymphocyte Transfusion
 

Citation

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Rizzieri, D. A., Dev, P., Long, G. D., Gasparetto, C., Sullivan, K. M., Horwitz, M., … Chao, N. J. (2009). Response and toxicity of donor lymphocyte infusions following T-cell depleted non-myeloablative allogeneic hematopoietic SCT from 3-6/6 HLA matched donors. Bone Marrow Transplant, 43(4), 327–333. https://doi.org/10.1038/bmt.2008.321
Rizzieri, D. A., P. Dev, G. D. Long, C. Gasparetto, K. M. Sullivan, Ml Horwitz, J. Chute, and N. J. Chao. “Response and toxicity of donor lymphocyte infusions following T-cell depleted non-myeloablative allogeneic hematopoietic SCT from 3-6/6 HLA matched donors.Bone Marrow Transplant 43, no. 4 (February 2009): 327–33. https://doi.org/10.1038/bmt.2008.321.
Rizzieri DA, Dev P, Long GD, Gasparetto C, Sullivan KM, Horwitz M, et al. Response and toxicity of donor lymphocyte infusions following T-cell depleted non-myeloablative allogeneic hematopoietic SCT from 3-6/6 HLA matched donors. Bone Marrow Transplant. 2009 Feb;43(4):327–33.
Rizzieri, D. A., et al. “Response and toxicity of donor lymphocyte infusions following T-cell depleted non-myeloablative allogeneic hematopoietic SCT from 3-6/6 HLA matched donors.Bone Marrow Transplant, vol. 43, no. 4, Feb. 2009, pp. 327–33. Pubmed, doi:10.1038/bmt.2008.321.
Rizzieri DA, Dev P, Long GD, Gasparetto C, Sullivan KM, Horwitz M, Chute J, Chao NJ. Response and toxicity of donor lymphocyte infusions following T-cell depleted non-myeloablative allogeneic hematopoietic SCT from 3-6/6 HLA matched donors. Bone Marrow Transplant. 2009 Feb;43(4):327–333.

Published In

Bone Marrow Transplant

DOI

EISSN

1476-5365

Publication Date

February 2009

Volume

43

Issue

4

Start / End Page

327 / 333

Location

England

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Transplantation Conditioning
  • Tissue Donors
  • T-Lymphocytes
  • Survivors
  • Prospective Studies
  • Myeloablative Agonists
  • Middle Aged
  • Lymphocyte Transfusion