Donor Lymphocyte Infusion for Relapsed Hematological Malignancies after Allogeneic Hematopoietic Cell Transplantation: Prognostic Relevance of the Initial.

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Donor Lymphocyte Infusion for Relapsed Hematological Malignancies after Allogeneic Hematopoietic Cell Transplantation: Prognostic Relevance of the Initial CD3+ T Cell Dose Merav Bar, Brenda M. Sandmaier, Yoshihiro Inamoto, Benedetto Bruno, Parameswaran Hari, Thomas Chauncey, Paul J. Martin, Rainer Storb, David G. Maloney, Barry Storer, Mary E.D. Flowers Biology of Blood and Marrow Transplantation Volume 19, Issue 6, Pages 949-957 (June 2013) DOI: 10.1016/j.bbmt.2013.03.001 Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 Outcome after donor lymphocyte infusion (DLI) according to initial DLI cell dose. (A) Shows cumulative incidence of graft-versus-host disease after DLI according to initial CD3+ cell dose. Twelve-month cumulative incidence of GVHD for initial DLI cell dose group A (≤1 × 107 CD3+ cell/kg) was 21%, compared with 45% (P = .01) for initial cell dose group B (>1 × 107 to <10 × 107 CD3+ cell/kg) and 55% (P < .0001) for initial cell dose group C (≥10 × 107 CD3+ cell/kg). (B) Shows overall survival after DLI according to initial CD3+ cell dose. Three-year overall survival rates were 47% for cell dose group A, 45% (P = .16) for cell dose group B, and 32% for cell dose group C (P = .01). Biology of Blood and Marrow Transplantation 2013 19, 949-957DOI: (10.1016/j.bbmt.2013.03.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 Overall survival after donor lymphocyte infusion (DLI) according to initial CD3+ cell dose and disease risk category. (A) Shows the overall survival for the low-risk category. One- and 3-year overall survival were 94% and 73% for cell dose A, 67% and 53% for cell dose B, and 60% and 55% for cell dose C (P = .07). Low-risk category included chronic myeloid leukemia-chronic phase and chronic lymphocytic leukemia, multiple myeloma, and low-risk lymphomas. (B) Shows the overall survival for the high-risk category. One- and 3-year overall survival were 47% and 27% for cell dose group A, 60% and 42% for cell dose group B, and 41% and 22% for cell dose group C (P = .35). High-risk category included high-risk myeloid malignancies (acute myeloid leukemia, myelodysplastic syndrome, chronic myeloid leukemia [blast crisis, accelerated phase], myelofibrosis, myeloproliferative disorders, and high-risk lymphoid malignancies [acute lymphoblastic leukemia, high-grade lymphomas [Hodgkin lymphoma, diffuse large B cell lymphoma, transformed non-Hodgkin lymphoma]). Biology of Blood and Marrow Transplantation 2013 19, 949-957DOI: (10.1016/j.bbmt.2013.03.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions