A Retrospective Comparison of DLI and gDLI for Post-Transplant Treatment

Sylvain Lamure (1, 2) , Franciane Paul (2) , Anne-Laure Gagez (2, 3) , Jérémy Delage (2) , Laure Vincent (2) , Nathalie Fegueux (2) , Anne Sirvent (2) , Eve Gehlkopf (2) , Jean Luc Veyrune (2, 4) , Lu Zhao Yang (2, 3) , Tarik Kanouni (2) , Valère Cacheux (2) , Jérôme Moreaux (5, 6, 2, 4) , Beatrice Bonafoux (2) , Guillaume Cartron (5, 2, 1) , John de Vos (2, 3) , Patrice Ceballos (2)

1 IGMM - Institut de Génétique Moléculaire de Montpellier
2 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
3 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)
4 IGH - Institut de génétique humaine
5 UM - Université de Montpellier
6 IUF - Institut universitaire de France

Donor lymphocyte infusion (DLI) is used to prevent or treat haematological malignancies relapse after allogeneic stem cell transplantation (allo-SCT). Recombinant human granulocyte colony-stimulated factor primed DLI (gDLI) is derived from frozen aliquots of the peripheral blood stem cell collection. We compared the efficacy and safety of gDLI and classical DLI after allo-SCT. We excluded haploidentical allo-SCT. Initial diseases were acute myeloblastic leukaemia (n = 45), myeloma (n = 38), acute lymphoblastic leukaemia (n = 20), non-Hodgkin lymphoma (n = 10), myelodysplasia (n = 8), Hodgkin lymphoma (n = 8), chronic lymphocytic leukaemia (n = 7), chronic myeloid leukaemia (n = 2) and osteomyelofibrosis (n = 1). Indications for DLI were relapse (n = 96) or pre-emptive treatment (n = 43). Sixty-eight patients had classical DLI and 71 had gDLI. The response rate was 38.2%, the 5-year progression-free survival (PFS) rate was 38% (29–48) and the 5-year overall survival (OS) rate was 37% (29–47). Graft versus host disease rate was 46.7% and 10.1% of patients died from toxicity. There were no differences between classical DLI and gDLI in terms of response (p = 0.28), 5-year PFS (p = 0.90), 5-year OS (p. 0.50), GvHD (p = 0.86), treated GvHD (p = 0.81) and cause of mortality (p. 0.14). In conclusion, this study points out no major effectiveness or toxicity of gDLI compared to classical DLI.

Mots clés: Donor lymphocyte infusion; Allogeneic stem cell transplantation; Post-transplant treatment

Domaines: Immunologie; Cancer; Hématologie

Sylvain Lamure, Franciane Paul, Anne-Laure Gagez, Jérémy Delage, Laure Vincent, et al.. A Retrospective Comparison of DLI and gDLI for Post-Transplant Treatment. Journal of Clinical Medicine, 2020, 9 (7), pp.2204. ⟨10.3390/jcm9072204⟩. ⟨hal-03203259⟩