Long-term results and GvHD after prophylactic and preemptive donor lymphocyte infusion after allogeneic stem cell transplantation for acute leukemia - Aix-Marseille Université
Article Dans Une Revue Bone Marrow Transplantation Année : 2022

Long-term results and GvHD after prophylactic and preemptive donor lymphocyte infusion after allogeneic stem cell transplantation for acute leukemia

Christoph Schmid (1) , Myriam Labopin (2, 3) , Nicolaas Schaap (4) , Hendrik Veelken (5) , Arne Brecht (6) , Michael Stadler (7) , Juergen Finke (8) , Frederic Baron (9) , Matthew Collin (10) , Gesine Bug (11) , Per Ljungman (12) , Didier Blaise (13, 14) , Johanna Tischer (15) , Adrian Bloor (16) , Aleksander Kulagin (17) , Sebastian Giebel (18) , Norbert-Claude Gorin (2) , Jordi Esteve (19) , Fabio Ciceri (20) , Bipin Savani (21) , Arnon Nagler (22) , Mohamad Mohty (2, 3)
1 UNIA - Universität Augsburg [Deutschland] = University of Augsburg [Germany] = Université d'Augsburg [Allemagne]
2 CHU Saint-Antoine [AP-HP]
3 CRSA - Centre de Recherche Saint-Antoine
4 Radboud University Medical Center [Nijmegen]
5 LUMC - Leiden University Medical Center
6 DKD HELIOS Medical Center - DKD Helios Klinik Wiesbaden [Wiesbaden, Germany]
7 MHH - Medizinische Hochschule Hannover = Hannover Medical School
8 Albert-Ludwigs-Universität Freiburg = University of Freiburg
9 Université de Liège
10 Newcastle Upon Tyne Hospitals NHS Foundation Trust
11 Goethe University Frankfurt
12 Karolinska University Hospital [Stockholm]
13 CRCM - Centre de Recherche en Cancérologie de Marseille
14 IPC - Institut Paoli-Calmettes
15 LMU - Ludwig Maximilian University [Munich] = Ludwig Maximilians Universität München
16 The Christie NHS Foundation Trust [Manchester, Royaume-Uni]
17 Ratsa Gorbacheva Memorial Children's Institute [St. Petersburg, Russian Federation]
18 MCMCC - Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology
19 Clinic Barcelona Hospital Universitari
20 San Raffaele Scientific Institute
21 Vanderbilt University Medical Center [Nashville]
22 TAU - Tel Aviv University
Christoph Schmid
Universität Augsburg [Deutschland] = University of Augsburg [Germany] = Université d'Augsburg [Allemagne]
Myriam Labopin
CHU Saint-Antoine [AP-HP]
Centre de Recherche Saint-Antoine
Nicolaas Schaap
  • Fonction : Auteur
Radboud University Medical Center [Nijmegen]
Hendrik Veelken
Leiden University Medical Center
Arne Brecht
  • Fonction : Auteur
DKD Helios Klinik Wiesbaden [Wiesbaden, Germany]
Michael Stadler
  • Fonction : Auteur
Medizinische Hochschule Hannover = Hannover Medical School
Juergen Finke
  • Fonction : Auteur
Albert-Ludwigs-Universität Freiburg = University of Freiburg
Frederic Baron
Université de Liège
Matthew Collin
Newcastle Upon Tyne Hospitals NHS Foundation Trust
Gesine Bug
  • Fonction : Auteur
Goethe University Frankfurt
Per Ljungman
Karolinska University Hospital [Stockholm]
Didier Blaise
Centre de Recherche en Cancérologie de Marseille
Institut Paoli-Calmettes
CV
Johanna Tischer
  • Fonction : Auteur
Ludwig Maximilian University [Munich] = Ludwig Maximilians Universität München
Adrian Bloor
The Christie NHS Foundation Trust [Manchester, Royaume-Uni]
Aleksander Kulagin
Ratsa Gorbacheva Memorial Children's Institute [St. Petersburg, Russian Federation]
Sebastian Giebel
Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology
Norbert-Claude Gorin
  • Fonction : Auteur
CHU Saint-Antoine [AP-HP]
Jordi Esteve
Clinic Barcelona Hospital Universitari
Fabio Ciceri
San Raffaele Scientific Institute
Bipin Savani
Vanderbilt University Medical Center [Nashville]
Arnon Nagler
Tel Aviv University
Mohamad Mohty
CHU Saint-Antoine [AP-HP]
Centre de Recherche Saint-Antoine

Résumé

Abstract We report on 318 patients with acute leukemia, receiving donor lymphocyte infusion (DLI) in complete hematologic remission (CHR) after allogeneic stem cell transplantation (alloSCT). DLI were applied preemptively (preDLI) for minimal residual disease (MRD, n = 23) or mixed chimerism (MC, n = 169), or as prophylaxis in high-risk patients with complete chimerism and molecular remission (proDLI, n = 126). Median interval from alloSCT to DLI1 was 176 days, median follow-up was 7.0 years. Five-year cumulative relapse incidence (CRI), non-relapse mortality (NRM), leukemia-free and overall survival (LFS/OS) of the entire cohort were 29.1%, 12.7%, 58.2%, and 64.3%. Cumulative incidences of acute graft-versus-host disease (aGvHD) grade II–IV°/chronic GvHD were 11.9%/31%. Nineteen patients (6%) died from DLI-induced GvHD. Age ≥60 years ( p = 0.046), advanced stage at transplantation ( p = 0.003), shorter interval from transplantation ( p = 0.018), and prior aGvHD ≥II° ( p = 0.036) were risk factors for DLI-induced GvHD. GvHD did not influence CRI, but was associated with NRM and lower LFS/OS. Efficacy of preDLI was demonstrated by decreasing MRD/increasing blood counts in 71%, and increasing chimerism in 70%. Five-year OS after preDLI for MRD/MC was 51%/68% among responders, and 37% among non-responders. The study describes response and outcome of DLI in CHR and helps to identify candidates without increased risk of severe GvHD.

Domaines

Cancer Immunologie

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https://amu.hal.science/hal-03623692

Soumis le : mardi 29 mars 2022-18:32:46

Dernière modification le : lundi 23 septembre 2024-10:28:31

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Dates et versions

hal-03623692 , version 1 (29-03-2022)

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Citer

Christoph Schmid, Myriam Labopin, Nicolaas Schaap, Hendrik Veelken, Arne Brecht, et al.. Long-term results and GvHD after prophylactic and preemptive donor lymphocyte infusion after allogeneic stem cell transplantation for acute leukemia. Bone Marrow Transplantation, 2022, 57 (2), pp.215-223. ⟨10.1038/s41409-021-01515-3⟩. ⟨hal-03623692⟩

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