Clinical and immunologic outcomes following haplocompatible donor lymphocyte infusions

We retrospectively analyzed the characteristics of 16 consecutive pediatric patients who received one or more G-CSF-mobilized donor lymphocyte infusions (DLI) following a T-cell-depleted haplocompatible hematopoietic SCT (HSCT) to enhance immune recovery and/or treat an infection. The median time from HSCT to administration of first DLI was 12 weeks and the median dose of DLI administered was 3 × 10 4 /kg (range, 2.5–6 × 10 4 /kg). The incidence of Grade I–II acute GVHD was 19% (95% confidence interval (CI), 6–44%), and there were no cases of Grade III–IV acute GVHD. Chronic GVHD developed in 13% (95% CI, 2–37%) of patients. In surviving patients who did not undergo a second stem cell infusion, T-cell numbers and function increased to a protective level in a median of 3 months (range, 2–12.5 months) following the first DLI administration. In patients given DLI for treatment of an infection, 75% (95% CI, 46–92%) cleared their infection after a median of 9 weeks (range, 1–27 weeks). In patients with CMV infection, the development of CMV-specific T cells was observed following DLI. The 1-year overall survival following haplocompatible DLI was 71% (95% CI, 59–83%), with a median follow-up of 16 months from the first DLI.