Ontology type: schema:ScholarlyArticle
2022-01-06
AUTHORSKaito Harada, Shohei Mizuno, Shingo Yano, Akiyoshi Takami, Hiroto Ishii, Kazuhiro Ikegame, Yuho Najima, Shinichi Kako, Takashi Ashida, Souichi Shiratori, Shuichi Ota, Makoto Onizuka, Kentaro Fukushima, Takahiro Fukuda, Tatsuo Ichinohe, Yoshiko Atsuta, Masamitsu Yanada
ABSTRACTAlthough haploidentical donor lymphocyte infusion (DLI) is a valid treatment option for relapsed acute myeloid leukemia (AML), the incidence and risk factors for graft-versus-host disease (GVHD) and the efficacy of haploidentical DLI have not been fully evaluated. We retrospectively analyzed the outcomes after haploidentical DLI for 84 patients with AML using a nationwide database and additional questionnaires. The median number of DLI cycles and infused CD3+ cell dose was 1 and 1.0 × 106/kg, respectively. The infused CD3+ cell count of 5.0 × 105/kg or higher was associated with acute GVHD (grade II–IV, 32.1% vs. 10.5%, p = 0.03; grade III–IV, 21.4% vs. 5.3%, p = 0.10). Patients who developed grade III–IV acute GVHD more frequently succumbed to treatment-related mortality (46.7% vs. 15.8% at 1 year, p = 0.002), although the relapse-related mortality was significantly low (40.0% vs. 72.2% at 1 year, p = 0.025). The overall response to DLI was significantly higher in the preemptive DLI group (47.4%) than in the therapeutic group (13.9%, p = 0.002). In the multivariate analysis, preemptive DLI was the predictive factor for overall response (odds ratio, 5.58; p = 0.003). Our results indicated the substantial risk of acute GVHD after haploidentical DLI with CD3+ cell count of 5.0×105/kg or higher and the favorable outcomes after preemptive DLI. More... »
PAGES643-653
http://scigraph.springernature.com/pub.10.1007/s00277-021-04731-5
DOIhttp://dx.doi.org/10.1007/s00277-021-04731-5
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