Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Ann Hematol. 2023 Mar;102(3):629-639. doi: 10.1007/s00277-023-05093-w. Epub 2023 Jan 20.
For relapsed acute myeloid leukemia (AML) patients who received allogeneic hematopoietic stem cell transplantation, donor lymphocyte infusion (DLI) is an effective therapy. However, the cell source of DLI remains a topic of debate. In this study, we aimed to compare the efficacy and safety of G-CSF mobilized cells (G-DLI) with conventionally collected DLI (C-DLI). A total of 81 patients (50 C-DLI vs. 31 G-DLI) were assessed for clinical outcomes. There were no statistically significant differences in the baseline characteristics between the two groups including AML risk, donor types, interval from relapse to DLI, and infused CD3 cell count. Although not statistically significant, complete remission (CR) and chimerism conversion rates were higher in G-DLI than in C-DLI: 51.6% vs. 28.0%, P = 0.057 and 42.3% vs. 28.2%, P = 0.363, respectively. There was no difference in acute graft-versus-host disease (GVHD) incidence and severity of acute GVHD between the two groups. The median overall survival (OS) of the G-DLI and C-DLI groups was 139 days and 106 days, respectively (P = 0.58). In conclusion, G-DLI appears to be a safe and an equally efficacious substitute for C-DLI, which is more readily available.
对于接受异基因造血干细胞移植的复发性急性髓系白血病 (AML) 患者,供者淋巴细胞输注 (DLI) 是一种有效的治疗方法。然而,DLI 的细胞来源仍是一个有争议的话题。在这项研究中,我们旨在比较粒细胞集落刺激因子动员细胞 (G-DLI) 与常规采集的 DLI (C-DLI) 的疗效和安全性。共评估了 81 例患者(50 例 C-DLI 与 31 例 G-DLI)的临床结局。两组患者的基线特征(包括 AML 风险、供者类型、复发至 DLI 的时间间隔和输注的 CD3 细胞计数)无统计学差异。尽管无统计学差异,但 G-DLI 的完全缓解 (CR) 和嵌合率高于 C-DLI:51.6%比 28.0%,P=0.057 和 42.3%比 28.2%,P=0.363。两组患者的急性移植物抗宿主病 (GVHD) 发生率和急性 GVHD 严重程度无差异。G-DLI 和 C-DLI 组的中位总生存期 (OS) 分别为 139 天和 106 天(P=0.58)。总之,G-DLI 似乎是一种安全且同样有效的 C-DLI 替代方案,因为它更容易获得。