Prevention of relapse using DLI can increase survival following HLA-identical transplantation in patients with advanced-stage acute leukemia: a multi-center study

Authors


  • Conflict of interest: The authors declare no financial disclosure.

Corresponding authors: Huang Xiao-Jun, Peking University People's Hospital, Institute of Hematology, Beijing 100044, China. Tel.: 861088326006; fax: 861088324577; e-mail: xjhrm@medmail.com.cn; Liu Qi-Fa, Nanfang Hospital, Nanfang Medical University, Guangzhou, Guangdong 510515, China. Tel.: 8620-61641612; fax: 8620-61641612; E-mail: liuqifa628@163.com; Wu De-Pei, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China. Tel.: 86512-67781; fax: 86512-67781851; E-mail: wudepei@medmail.com.cn

Abstract

A total of 123 consecutive patients with advanced-stage, acute leukemia undergoing HSCT from HLA-identical sibling donors were analyzed. A G-CSF-primed DLI was planned within day 60 post-transplantation before hematologic relapse was diagnosed. Fifty of the 123 individuals received prophylactic DLI, and 73 individuals received no prophylactic treatment. The incidence of grades II–IV acute graft-versus-host disease (GVHD) was 17% for patients receiving DLI and 23% for patients not receiving DLI (p = 0.35). The incidence of chronic GVHD was 38% for patients receiving DLI and 17% for patients not receiving DLI (p = 0.021). The two-yr cumulative incidence of relapse was significantly lower in patients who received prophylactic DLI (46%) compared with patients who did not receive prophylactic DLI (66%) (p = 0.02). The three-yr probability of overall survival was higher in patients who received prophylactic DLI (36%) than in patients who did not receive prophylactic DLI (11%) (p = 0.001). The leukemia-free survival was also higher in patients who received prophylactic DLI (29%) than in patients who did not receive prophylactic DLI (9%) (p = 0.001). Our comparisons suggest that the prophylactic use of DLI can significantly increase survival of patients with advanced-stage, acute leukemia who receive HLA-identical sibling HSCT.

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