Donor lymphocyte infusion (DLI) is a treatment option to prevent or treat relapse after allogeneic hematopoietic cell transplantation (HCT). We here report data for 173 patients who received one or multiple DLIs after haploidentical-HCT with post-transplant cyclophosphamide (PTCY) at 47 EBMT centers from 2009 to 2018. Indication for DLI was: prophylactic for 59 (34.3%), preemptive for 20(11.6%), and therapeutic for 93(54.1%). For the prophylactic group, the median number of DLIs was 1 (IQR:1-2.5) with a median first dose of 0.1 × 106 CD3+ T cell/kg, for the preemptive 2 (IQR:1-3) with 0.5 × 106 CD3+ T cell/kg, for the therapeutic 1 (IQR:1-3) with 1 × 106CD3+ Tcell/kg, respectively. OS after first DLI was 61% (46-75%) for prophylactic, 40% (19-61%) for preemptive, and 22% (13-31%) for therapeutic. CI of II-IV aGVHD and cGVHD was 17% (7-27%) and 53% (40-67%) for the prophylactic, 20% (2-38%) and 21% (3-39%) for the preemptive, 17% (9-24%) and 24% (15-33%) for the therapeutic group, respectively. Our data show great variability in the indications and modalities of DLI across responding EBMT centers. Survival rates remain relatively low in patients with active disease. While the cumulative incidence of aGVHD appears acceptable, we showed a high incidence of cGVHD in the prophylactic group, compared with preemptive and therapeutic DLI. These data should be investigated further in prospective clinical trials.

Anadolu Medical Center Hospital Kocaeli Turkey

Demiroglu Bilim University Istanbul Florence Nightingale Hospital Istanbul Istanbul Turkey

Department of Hematology and Oncology Ospedale Civile Santo Spirito Pescara Italy

EBMT Leiden Study Unit Leiden The Netherlands

EBMT Statistical Unit Leiden The Netherlands

Hospital U Marqués de Valdecilla Santander Spain

Hospital Universitario Reina Sofia IMIBIC University of Cordoba Cordoba Spain

Institut Paoli Calmettes Centre de Lutte Contre le Cancer and Centre d'Investigations Cliniques en Biothérapie Université d'Aix Marseille Inserm CBT 1409 Marseille France

Institut Paoli Calmettes Centre de Lutte Contre le Cancer and Centre de Recherches en Cancérologie de Marseille Inserm UMR 1068 Université d'Aix Marseille Marseille France

Institute of Hematology and Blood Transfusion Prague Czech Republic

Institute of Hematology Centro Ricerche Emato Oncologiche Ospedale S Maria della Misericordia University of Perugia Perugia Italy

Istituto Clinico Humanitas Milano Italy

Leiden University Medical Center Leiden The Netherlands

Medicana International Hospital Istanbul Istanbul Turkey

RM Gorbacheva Research Institute Pavlov University St Petersburg Russia

San Raffaele Scientific Institute Hematology and Bone marrow Transplantation unit Milan Italy

Servicio de Hematología Hospital G Universitario Gregorio Marañon Instituto de Investigación sanitaria Gregorio Marañon Department of Medicine Universidad Complutense Madrid Spain

Bone Marrow Transplant. 2023 Jan;58(1):119-120. doi: 10.1038/s41409-022-01855-8. PubMed

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