Clinical and immunologic outcomes following haplocompatible donor lymphocyte infusions

Bone Marrow Transplant. 2009 Dec;44(12):805-12. doi: 10.1038/bmt.2009.87. Epub 2009 May 4.

Abstract

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 x 10(4)/kg (range, 2.5-6 x 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.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Blood Donors*
  • Child
  • Child, Preschool
  • Chronic Disease
  • 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
  • Haplotypes
  • Hematologic Neoplasms / blood
  • Hematologic Neoplasms / immunology
  • Hematologic Neoplasms / mortality
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Infant
  • Lymphocyte Transfusion*
  • Male
  • Recovery of Function / immunology*
  • Retrospective Studies
  • Severe Combined Immunodeficiency / blood
  • Severe Combined Immunodeficiency / immunology
  • Severe Combined Immunodeficiency / mortality
  • Severe Combined Immunodeficiency / therapy
  • Survival Rate
  • Time Factors
  • Transplantation, Homologous