The Role of Donor Lymphocyte Infusion (DLI) in Post-Hematopoietic Cell Transplant (HCT) Relapse for Chronic Myeloid Leukemia (CML) in the Tyrosine Kinase Inhibitor (TKI) Era.

Schmidt, Sarah; Liu, Ying; Hu, Zhen-Huan; Williams, Kirsten M; Lazarus, Hillard M; Vij, Ravi; Kharfan-Dabaja, Mohamed A; Ortí, Guillermo; Wiernik, Peter H; Weisdorf, Daniel; Kamble, Rammurti T; Herzig, Roger; Wirk, Baldeep; Cerny, Jan; Bacher, Ulrike; Chaudhri, Naeem A; Nathan, Sunita; Farhadfar, Nosha; Aljurf, Mahmoud; Gergis, Usama; ... (2020). The Role of Donor Lymphocyte Infusion (DLI) in Post-Hematopoietic Cell Transplant (HCT) Relapse for Chronic Myeloid Leukemia (CML) in the Tyrosine Kinase Inhibitor (TKI) Era. Biology of blood and marrow transplantation, 26(6), pp. 1137-1143. Elsevier 10.1016/j.bbmt.2020.02.006

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Treatment for relapse of chronic myeloid leukemia (CML) following hematopoietic cell transplantation (HCT) includes tyrosine kinase inhibitors (TKIs) with or without donor lymphocyte infusions (DLIs), but the most effective treatment strategy is unknown. This study was performed through the Center for International Blood and Marrow Transplant Research (CIBMTR) database. We retrospectively reviewed all patients reported to the CIBMTR registry from 2002 to 2014 who underwent HCT for CML and were alive 30 days postrelapse. A total of 215 HCT recipients relapsed and were analyzed in the following groups: (1) TKI alone (n = 128), (2) TKI with DLI (n = 48), and (3) DLI without TKI (n = 39). In multivariate analysis, disease status prior to HCT had a significant effect on overall survival (OS). Patients who received a DLI alone compared with a TKI with a DLI had inferior survival (hazard ratio, 2.28; 95% confidence interval, 1.23 to 4.24; P= .009). Those who received a TKI alone had similar survival compared with those who received a TKI with a DLI (P = .81). These data support that despite use of TKIs pretransplantation, TKI salvage therapy continues to provide significant survival following relapse in patients with CML following HCT. These data do not suggest that adding a DLI to a TKI adds an improvement in OS.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory

UniBE Contributor:

Bacher, Vera Ulrike

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1083-8791

Publisher:

Elsevier

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

15 Jun 2020 11:33

Last Modified:

15 Jun 2020 11:33

Publisher DOI:

10.1016/j.bbmt.2020.02.006

PubMed ID:

32062061

Uncontrolled Keywords:

Chronic myeloid leukemia Donor lymphocyte infusion Hematopoietic cell transplantation Tyrosine kinase inhibitor

BORIS DOI:

10.7892/boris.144469

URI:

https://boris.unibe.ch/id/eprint/144469

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