造血干细胞移植后白血病复发的供体淋巴细胞输注
Donor lymphocyte infusion for leukemia relapse after hematopoietic stem cell transplantation.
作者信息
Yegin Zeynep Arzu, Ozkurt Zübeyde Nur, Aki Sahika Zeynep, Sucak Gülsan Türköz
机构信息
Gazi University, Faculty of Medicine, Department of Hematology, Ankara, Turkey.
出版信息
Transfus Apher Sci. 2010 Jun;42(3):239-45. doi: 10.1016/j.transci.2010.03.011. Epub 2010 Apr 10.
Leukemia relapse is a serious therapeutic challenge following hematopoietic stem cell transplantation (HSCT). In this retrospective study, 23 patients [15 (65.2%) AML, 8 (34.8%) ALL] who received DLI+/-reinduction chemotherapy for post-transplant relapse were reviewed. The overall response rate of DLI was 66.7% for AML and 50% for ALL. A total of 15 patients (65.2%) developed acute graft versus host disease (GVHD). Response rates were higher in patients with GVHD (80% versus 25%; p=0.01; OR: 12.0). The probability of OS was better in patients who respond to DLI (p=0.04). Further strategies are required to improve the anti-tumor properties of alloreactive donor lymphocytes and to obtain durable responses with DLI in patients with relapsed acute leukemia after allogeneic HSCT.
白血病复发是造血干细胞移植（HSCT）后一项严峻的治疗挑战。在这项回顾性研究中，对23例接受供体淋巴细胞输注（DLI）±再诱导化疗以治疗移植后复发的患者[15例（65.2%）急性髓系白血病（AML），8例（34.8%）急性淋巴细胞白血病（ALL）]进行了回顾。DLI对AML的总体缓解率为66.7%，对ALL为50%。共有15例患者（65.2%）发生了急性移植物抗宿主病（GVHD）。发生GVHD的患者缓解率更高（80%对25%；p=0.01；比值比：12.0）。对DLI有反应的患者总生存期概率更好（p=0.04）。需要进一步的策略来提高同种异体反应性供体淋巴细胞的抗肿瘤特性，并使异基因HSCT后复发的急性白血病患者通过DLI获得持久缓解。
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