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2024-12-23T09:40:30.000Z

GvHD prophylaxis with donor lymphocyte infusion in patients treated with PTCy

Dec 23, 2024
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Learning objective: After reading this article, learners will be able to cite a new clinical development in graft-versus-host disease.

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A multicenter retrospective cohort study assessed the safety and efficacy of DLI in 162 patients treated with PTCy and transplanted between 2015 and 2022 within the Center for Immuno-Oncology at the National Cancer Institute.1 A total of 21 patients received ≥1 DLI after 22 PTCy-based transplants. Results were published in Bone Marrow Transplantationby Shanmugasundaram et al.1


Key learnings
Low incidences of aGvHD (7.8%), CRS (7.8%), and cGvHD (2.6%) were observed in patients who received DLI, all of whom underwent serotherapy-containing pre-HCT conditioning.
The CR rate with DLI was low overall (18.4%), and in patients with disease relapse (11%) and mixed chimerism or delayed engraftment (15%). 
The CR rate was higher in patients who received serotherapy conditioning pre-transplant vs those who did not (30% vs 4.3%).
Although DLI was safe and lowered the risk of GvHD in patients treated with PTCy, it demonstrated limited efficacy in preventing disease relapse or achieving long-term disease control. Further research to identify strategies to enhance the efficacy of DLI is needed. 

Abbreviations: aGvHD, acute GvHD; cGvHD, chronic GvHD; CR, complete response; CRS, cytokine release syndrome; DLI, donor lymphocyte infusion; GvHD, graft-versus-host disease; PTCy, post-transplant cyclophosphamide. 

  1. Shanmugasundaram K, Napier S, Dimitrova D, et al. Safety but limited efficacy of donor lymphocyte infusion for post-transplantation cyclophosphamide-treated patients. Bone Marrow Transplant. 2024;59(11):1513-1524. DOI:

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