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Prevention of relapse using DLI can increase survival following HLA ‐identical transplantation in patients with advanced‐stage acute leukemia: a multi‐center study
Author(s) -
Wang Yu,
Liu DaiHong,
Fan ZhiPing,
Sun Jing,
Wu XiaoJin,
Ma Xiao,
Xu LanPing,
Liu KaiYan,
Liu QiFa,
Wu DePei,
Huang XiaoJun
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2012.01626.x
Subject(s) - medicine , incidence (geometry) , cumulative incidence , single center , gastroenterology , transplantation , leukemia , acute leukemia , human leukocyte antigen , stage (stratigraphy) , surgery , immunology , antigen , paleontology , physics , optics , biology
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 .