Selected large studies of donor lymphocyte infusion after allogeneic hematopoietic-cell transplantation (HCT).
| Reference . | N . | Diagnoses . | Cell dose; Type . | Outcome . | Comments . |
|---|---|---|---|---|---|
| Abbreviations: CML, chronic myeloid leukemia; CP, chronic phase; AML, acute myeloid leukemia; ALL, acute lymphoblastic leukemia; GVHD, graft-versus-host disease; DLI, donor lymphocyte infusion; OS, overall survival; DFS, disease-free survival; Cy, cyclophosphamide; Flu, fludarabine; CR, complete remission | |||||
| Kolb et al (1995)19 | 135 | various | Median 3.0 × 108/kg; mononuclear cells | 2 yr OS 68% for CML vs. <20% for AML & ALL | Higher response rates in CML patients who developed GVHD after DLI |
| Collins et al (1997)24 | 140 | various | Mean 4.7 × 108/kg; mononuclear cells | 2 yr OS 60% for CML vs. <20% for AML & ALL | Higher response rates in CML patients with early stage disease & post-HCT chronic GVHD; development of GVHD after DLI correlated with response |
| Dazzi et al (2000)17 | 66 | CML | Median 1.5 × 108/kg; lymphocytes | 3 yr OS 95% in responders vs. 53% in non-responders | Higher response rates in early phase disease and longer remission duration after HCT |
| Porter et al (2000)25 | 58 | various | Median 1.0 × 108/kg; mononuclear cells | 2 yr DFS 65% for CML vs. ~25% for AML & ALL | DLI from matched unrelated donors; higher response rates in longer remission duration after HCT |
| Guglielmi et al (2002)18 | 344 | CML | Median 1.0 × 108/kg; mononuclear cells | 2 yr OS ~70% | Low-dose DLI (0.2 × 108 mononuclear cells/kg) leads to similar response but lower GVHD than high-dose DLI |
| Levine et al (2002)26 | 65 | various (no CML CP) | 1.0 × 108/kg; CD3+ cells | 2 yr OS 19% | Patients received cytarabine-based chemotherapy; higher response rates in longer remission duration after HCT; GVHD not required for durable remission |
| Mielcarek et al (2007)20 | 65 | various (no CML CP) | 1.0 × 108/kg (related), 1.0 × 107/kg (unrelated); CD3+ cells | Survival/response not described | Subset of patients in a cohort of 307 patients with post- HCT relapse; DLI not associated with response or survival |
| Miller et al (2007)27,29 | 78 | various | 1.0 × 108/kg; CD3+ cells | 2 yr OS 75% for CML vs. 17% for non-CML | 15 pts received Cy-Flu chemotherapy; lymphodepleting chemotherapy increased risk of severe acute GVHD |
| Schmid et al (2007)28 | 171 | AML | Median 2.8 × 108/kg; mononuclear cells | 2 yr OS 21% | Higher response rates if low disease bulk at relapse, favorable cytogenetics and in CR at DLI; development of chronic GVHD after DLI correlated with response |
| Reference . | N . | Diagnoses . | Cell dose; Type . | Outcome . | Comments . |
|---|---|---|---|---|---|
| Abbreviations: CML, chronic myeloid leukemia; CP, chronic phase; AML, acute myeloid leukemia; ALL, acute lymphoblastic leukemia; GVHD, graft-versus-host disease; DLI, donor lymphocyte infusion; OS, overall survival; DFS, disease-free survival; Cy, cyclophosphamide; Flu, fludarabine; CR, complete remission | |||||
| Kolb et al (1995)19 | 135 | various | Median 3.0 × 108/kg; mononuclear cells | 2 yr OS 68% for CML vs. <20% for AML & ALL | Higher response rates in CML patients who developed GVHD after DLI |
| Collins et al (1997)24 | 140 | various | Mean 4.7 × 108/kg; mononuclear cells | 2 yr OS 60% for CML vs. <20% for AML & ALL | Higher response rates in CML patients with early stage disease & post-HCT chronic GVHD; development of GVHD after DLI correlated with response |
| Dazzi et al (2000)17 | 66 | CML | Median 1.5 × 108/kg; lymphocytes | 3 yr OS 95% in responders vs. 53% in non-responders | Higher response rates in early phase disease and longer remission duration after HCT |
| Porter et al (2000)25 | 58 | various | Median 1.0 × 108/kg; mononuclear cells | 2 yr DFS 65% for CML vs. ~25% for AML & ALL | DLI from matched unrelated donors; higher response rates in longer remission duration after HCT |
| Guglielmi et al (2002)18 | 344 | CML | Median 1.0 × 108/kg; mononuclear cells | 2 yr OS ~70% | Low-dose DLI (0.2 × 108 mononuclear cells/kg) leads to similar response but lower GVHD than high-dose DLI |
| Levine et al (2002)26 | 65 | various (no CML CP) | 1.0 × 108/kg; CD3+ cells | 2 yr OS 19% | Patients received cytarabine-based chemotherapy; higher response rates in longer remission duration after HCT; GVHD not required for durable remission |
| Mielcarek et al (2007)20 | 65 | various (no CML CP) | 1.0 × 108/kg (related), 1.0 × 107/kg (unrelated); CD3+ cells | Survival/response not described | Subset of patients in a cohort of 307 patients with post- HCT relapse; DLI not associated with response or survival |
| Miller et al (2007)27,29 | 78 | various | 1.0 × 108/kg; CD3+ cells | 2 yr OS 75% for CML vs. 17% for non-CML | 15 pts received Cy-Flu chemotherapy; lymphodepleting chemotherapy increased risk of severe acute GVHD |
| Schmid et al (2007)28 | 171 | AML | Median 2.8 × 108/kg; mononuclear cells | 2 yr OS 21% | Higher response rates if low disease bulk at relapse, favorable cytogenetics and in CR at DLI; development of chronic GVHD after DLI correlated with response |