TY - JOUR

T1 - Donor Lymphocyte Infusion Is a Feasible Way to Improve Survival in Patients with Acute Myeloid Leukemia and Myelodysplastic Syndromes Who Relapse after Allogeneic Stem Cell Transplantation

AU - Minculescu, Lia

AU - Reekie, Joanne

AU - Petersen, Soeren Lykke

AU - Kornblit, Brian Thomas

AU - Schjoedt, Ida

AU - Andersen, Niels Smedegaard

AU - Andersen, Lisbeth Pernille

AU - Fischer-Nielsen, Anne

AU - Haastrup, Eva Kannik

AU - Friis, Lone Smidstrup

AU - Sengelov, Henrik

N1 - Funding Information: This work was supported by grants from the Novo Nordisk Foundation (NNF200C006347). Publisher Copyright: © 2023 S. Karger AG. All rights reserved.

PY - 2023

Y1 - 2023

N2 - Introduction: Donor lymphocyte infusion (DLI) is used to induce remission in patients who relapse after allogeneic stem cell transplantation (allo-HSCT). During the last decade, the hypomethylating agent Azacitidine has been used together with DLI for a synergistic graft-versusleukemia (GVL) effect. Here, we report results of DLI/ Azacitidine treatment from a retrospective singlecenter study. Methods: Fifty AML/MDS patients treated for relapse after allo-HSCT between 2001 and 2020 with DLI at the Department of Hematology, at Rigshospitalet, Copenhagen University Hospital were included for analyses. A subgroup of patients who obtained complete remission (CR) after reinduction chemotherapy, received DLI in combination with low-dose (32 mg/m2) Azacitidine. Results: Overall survival in all patients after DLI treatment was 59% at 2 years and 20% at 5 years. Relapsefree survival in patients in CR prior to DLI was 32% after 2 years and 7% after 5 years. In the DLI + low-dose- Azacitidine group, 5-year relapse-free survival was 40%. Conclusion: DLI remains an effective treatment in posttransplant relapse leaving one-fifth of patients? long-term survivors.Our results support the concomitant use of lowdose Azacitidine in the future use of DLI in order to enhance the GVL effect of donor lymphocytes. ? 2023 S. Karger AG, Basel.

AB - Introduction: Donor lymphocyte infusion (DLI) is used to induce remission in patients who relapse after allogeneic stem cell transplantation (allo-HSCT). During the last decade, the hypomethylating agent Azacitidine has been used together with DLI for a synergistic graft-versusleukemia (GVL) effect. Here, we report results of DLI/ Azacitidine treatment from a retrospective singlecenter study. Methods: Fifty AML/MDS patients treated for relapse after allo-HSCT between 2001 and 2020 with DLI at the Department of Hematology, at Rigshospitalet, Copenhagen University Hospital were included for analyses. A subgroup of patients who obtained complete remission (CR) after reinduction chemotherapy, received DLI in combination with low-dose (32 mg/m2) Azacitidine. Results: Overall survival in all patients after DLI treatment was 59% at 2 years and 20% at 5 years. Relapsefree survival in patients in CR prior to DLI was 32% after 2 years and 7% after 5 years. In the DLI + low-dose- Azacitidine group, 5-year relapse-free survival was 40%. Conclusion: DLI remains an effective treatment in posttransplant relapse leaving one-fifth of patients? long-term survivors.Our results support the concomitant use of lowdose Azacitidine in the future use of DLI in order to enhance the GVL effect of donor lymphocytes. ? 2023 S. Karger AG, Basel.

KW - Acute myeloid leukemia

KW - Allogeneic hematopoietic stem cell transplantation

KW - Donor lymphocyte infusion

KW - Graft-versustumor effect

KW - Hypomethylating agents

U2 - 10.1159/000534315

DO - 10.1159/000534315

M3 - Journal article

C2 - 37827141

AN - SCOPUS:85179092587

VL - 147

SP - 325

EP - 332

JO - Acta Haematologica

JF - Acta Haematologica

SN - 0001-5792

IS - 3

ER -