Lymphocyte infusion, donor

FIGURE 93-1. Algorithm for primary therapy in newly diagnosed CML patients. DU, donor lymphocyte infusion IFN, interferon. 

Slavin S. Morecki S. Weiss L, Or R Donor lymphocyte infusion the use of alloreactive and tumor-reactive lymphocytes for immunotherapy of malignant and non-malignant disease in conjunction with allogeneic stem cell transplantation. J Hematother Stem Cell Res 2002 11 265-276. 

Baron F, Beguin Y. Adoptive immunotherapy with donor lymphocyte infusions after allogeneic HPC transplantation. Transfusion 2000 40 468-476. 

The importance of detecting the bcr-abl fusion gene product in CML patients after alloHSCT was studied in 346 patients and 634 collected blood samples. A positive polymerase chain reaction (PCR) 3 months or 36 months after transplant did not predict for relapse, but a positive PCR at 6 or 12 months after transplant was highly predictive." With this tool, it may be possible to identify patients who are at high risk for clinical relapse and to treat them with donor lymphocyte infusion or imatinib in an attempt to suppress or eradicate residual disease. 

Raiola AM, Lint MV, Valbonesi M, et al. Factors predicting response and graft-versus-host disease after donor lymphocyte infusions A smdy on 593 infusions. Bone Marrow Transplant 2003 31 687-693. 

Dazzi F, Szydlo M, Craddock C, et al. Comparison of single dose and escalating dose regimens of donor lymphocyte infusion for relapse after allografting for chronic myelogenous leukemia. Blood 2000 95 67-71. 

Guglielmi C, Arcese W, Dazzi F, et al. Donor lymphocyte infusion for relapsed chronic myelogenous leukemia prognostic relevance of the initial cell dose. Blood 2002 100 397-405. 

Posttransplant immunotherapy is based on the graft-versus-tumor (CVT) effect caused by certain subsets of T cells responsible for eradication of malignant cells. Posttransplant immunotherapy includes the use of donor lymphocyte infusions, immunomodulatory cytokines, monoclonal antibodies, or antitumor vaccines. 

GVH alloresponses mediated by delayed donor lymphocyte infusions (DLI) can occur in the absence of GVHD. These GVH responses are confined to the lympho-hematopoietic system and mediate graft-versus-leukemia (GVL) reactions without causing GVHD. 

Kordes U, Binder TM, Eiermann TH, Hassenpflug-Diedrich B, Hassan MA, Beutel K, Nagy M, Kabisch H, Schneppenheim R. Successful donor-lymphocyte infusion for extreme immune-hemolysis following unrelated BMT in a patient with X-linked chronic... 

Fig. 6.1.3. Allogeneic hematopoietic cell transplantation (HCT) after reduced intensity conditioning (RIC). In the first weeks after transplant there is coexistence of donor and recipient hematopoietic cells (mixed chimerism). Spontaneously or after donor lymphocyte infusions (DLI) full donor chimerism is established...

Xia G, Kovochich M, Truitt RL, Johnson BD (2004) Tracking ex vivo-expanded CD4+CD25+ and CD8-hCD25+ regulatory T cells after infusion to prevent donor lymphocyte infusion-induced lethal acute graft-versus-host disease. Biol Blood Marrow Transplant 10 748-760... 

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