Comparison of Outcomes of Donor Lymphocyte Infusions With or Without Lenalidomide in Patients with Hematological Malignancies Post Allogeneic HSCT
Outcomes with DLI alone for post-transplant relapsed hematological malignancies are poor especially in acute leukemias. Addition of immunomodulatory drugs to DLI may augment GVL effect. Use of lenalidomide with DLI to augment GVL has not been previously reported. This retrospective analysis was to c...
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| Veröffentlicht in: | Indian journal of hematology & blood transfusion 2023-01, Vol.39 (1), p.40-49 |
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| creator | Punatar, Sachin Murugaiyan, Vinodhini Kumbhalwar, Komal Gokarn, Anant Chichra, Akanksha Mirgh, Sumeet Nayak, Lingaraj Bonda, Avinash Jindal, Nishant Shirure, Vijay Bagal, Bhausaheb Mathew, Libin Kannan, Sadhana Saikia, Tapan Khattry, Navin |
| description | Outcomes with DLI alone for post-transplant relapsed hematological malignancies are poor especially in acute leukemias. Addition of immunomodulatory drugs to DLI may augment GVL effect. Use of lenalidomide with DLI to augment GVL has not been previously reported. This retrospective analysis was to compare the outcomes of DLI with or without lenalidomide. All consecutive patients who received DLI from 01/2010 through 01/2020 were included. DLIs were given without any immunosuppression. Lenalidomide, when used, was given continuously, starting with 1st or subsequent DLI. Patients who received lenalidomide were compared with those who did not. Event (hematological relapse or death) free survival (EFS) and overall survival (OS) were calculated from 1st DLI. Primary objective was to compare OS. Secondary objectives were EFS, CR rates, acute GVHD, lenalidomide toxicities and DLI related mortality (TRM). Total 61 patients received DLI—43 without and 18 with lenalidomide; all outcomes in the 2 groups were similar. There were 26 patients with HLA-A*24 and/or HLA-B*40. Among these, trend towards improvement in OS (median OS not reached vs. 8 months, 4 year OS was 62% vs. 32%,
p
= 0.1) and EFS (median 9 vs. 1 month, 4 year EFS 50% vs. 22%,
p
= 0.1) was seen with lenalidomide. Overall, there was no improvement in outcomes by adding lenalidomide to DLI. However, among patients with HLA*24 or B*40, there was a trend to improved survival with lenalidomide. Use of lenalidomide to augment the GVL effect of DLI warrants further exploration. |
| doi_str_mv | 10.1007/s12288-022-01545-x |
| format | Article |
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p
= 0.1) and EFS (median 9 vs. 1 month, 4 year EFS 50% vs. 22%,
p
= 0.1) was seen with lenalidomide. Overall, there was no improvement in outcomes by adding lenalidomide to DLI. However, among patients with HLA*24 or B*40, there was a trend to improved survival with lenalidomide. Use of lenalidomide to augment the GVL effect of DLI warrants further exploration.</description><identifier>ISSN: 0971-4502</identifier><identifier>ISSN: 0974-0449</identifier><identifier>EISSN: 0974-0449</identifier><identifier>EISSN: 0971-4502</identifier><identifier>DOI: 10.1007/s12288-022-01545-x</identifier><identifier>PMID: 36699432</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Blood & organ donations ; Blood cancer ; Blood Transfusion Medicine ; Clinical outcomes ; Hematology ; Human Genetics ; Immunotherapy ; Lymphocytes ; Medicine ; Medicine & Public Health ; Oncology ; Original ; Original Article ; Stem cell transplantation ; Targeted cancer therapy</subject><ispartof>Indian journal of hematology & blood transfusion, 2023-01, Vol.39 (1), p.40-49</ispartof><rights>The Author(s), under exclusive licence to Indian Society of Hematology and Blood Transfusion 2022</rights><rights>The Author(s), under exclusive licence to Indian Society of Hematology and Blood Transfusion 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c360t-1c7b9c30678b40949d0233b1e24109e47559ea5a7f7eeb52b453b4a52acca6933</citedby><cites>FETCH-LOGICAL-c360t-1c7b9c30678b40949d0233b1e24109e47559ea5a7f7eeb52b453b4a52acca6933</cites><orcidid>0000-0001-9520-795X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868208/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868208/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,728,781,785,886,27929,27930,41493,42562,51324,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36699432$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Punatar, Sachin</creatorcontrib><creatorcontrib>Murugaiyan, Vinodhini</creatorcontrib><creatorcontrib>Kumbhalwar, Komal</creatorcontrib><creatorcontrib>Gokarn, Anant</creatorcontrib><creatorcontrib>Chichra, Akanksha</creatorcontrib><creatorcontrib>Mirgh, Sumeet</creatorcontrib><creatorcontrib>Nayak, Lingaraj</creatorcontrib><creatorcontrib>Bonda, Avinash</creatorcontrib><creatorcontrib>Jindal, Nishant</creatorcontrib><creatorcontrib>Shirure, Vijay</creatorcontrib><creatorcontrib>Bagal, Bhausaheb</creatorcontrib><creatorcontrib>Mathew, Libin</creatorcontrib><creatorcontrib>Kannan, Sadhana</creatorcontrib><creatorcontrib>Saikia, Tapan</creatorcontrib><creatorcontrib>Khattry, Navin</creatorcontrib><title>Comparison of Outcomes of Donor Lymphocyte Infusions With or Without Lenalidomide in Patients with Hematological Malignancies Post Allogeneic HSCT</title><title>Indian journal of hematology & blood transfusion</title><addtitle>Indian J Hematol Blood Transfus</addtitle><addtitle>Indian J Hematol Blood Transfus</addtitle><description>Outcomes with DLI alone for post-transplant relapsed hematological malignancies are poor especially in acute leukemias. Addition of immunomodulatory drugs to DLI may augment GVL effect. Use of lenalidomide with DLI to augment GVL has not been previously reported. This retrospective analysis was to compare the outcomes of DLI with or without lenalidomide. All consecutive patients who received DLI from 01/2010 through 01/2020 were included. DLIs were given without any immunosuppression. Lenalidomide, when used, was given continuously, starting with 1st or subsequent DLI. Patients who received lenalidomide were compared with those who did not. Event (hematological relapse or death) free survival (EFS) and overall survival (OS) were calculated from 1st DLI. Primary objective was to compare OS. Secondary objectives were EFS, CR rates, acute GVHD, lenalidomide toxicities and DLI related mortality (TRM). Total 61 patients received DLI—43 without and 18 with lenalidomide; all outcomes in the 2 groups were similar. There were 26 patients with HLA-A*24 and/or HLA-B*40. Among these, trend towards improvement in OS (median OS not reached vs. 8 months, 4 year OS was 62% vs. 32%,
p
= 0.1) and EFS (median 9 vs. 1 month, 4 year EFS 50% vs. 22%,
p
= 0.1) was seen with lenalidomide. Overall, there was no improvement in outcomes by adding lenalidomide to DLI. However, among patients with HLA*24 or B*40, there was a trend to improved survival with lenalidomide. Use of lenalidomide to augment the GVL effect of DLI warrants further exploration.</description><subject>Blood & organ donations</subject><subject>Blood cancer</subject><subject>Blood Transfusion Medicine</subject><subject>Clinical outcomes</subject><subject>Hematology</subject><subject>Human Genetics</subject><subject>Immunotherapy</subject><subject>Lymphocytes</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Original</subject><subject>Original Article</subject><subject>Stem cell transplantation</subject><subject>Targeted cancer therapy</subject><issn>0971-4502</issn><issn>0974-0449</issn><issn>0974-0449</issn><issn>0971-4502</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kc9uEzEQxleIipbCC3BAljgv-O96fUGqUtpUCmolijhaXsebuNr1BNtLm9foE-M0pZQLpxnp-803o_mq6h3BHwnG8lMilLZtjSmtMRFc1HcvqiOsJK8x5-rlQ09qLjA9rF6ndINxQxgXr6pD1jRKcUaPqvsZjBsTfYKAoEeXU7YwurTrTyFARIvtuFmD3WaHLkI_JQ8hoR8-r1ERdxWmjBYumMEvYfRLh3xAVyZ7F3JCtztw7kaTYYCVt2ZAXwu5CiZYX9ZcQcroZCiaC85bNP82u35THfRmSO7tYz2uvp99uZ7N68Xl-cXsZFFb1uBcEys7ZRluZNtxrLhaYspYRxzlBCvHpRDKGWFkL53rBO24YB03ghprTaMYO64-7303Uze6pS0HRzPoTfSjiVsNxut_leDXegW_tGqbluK2GHx4NIjwc3Ip6xuYYvlE0lQWpCFS0ULRPWUjpBRd_7SBYL3LUe9z1CVH_ZCjvitD75_f9jTyJ7gCsD2QihRWLv7d_R_b36WbrKs</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Punatar, Sachin</creator><creator>Murugaiyan, Vinodhini</creator><creator>Kumbhalwar, Komal</creator><creator>Gokarn, Anant</creator><creator>Chichra, Akanksha</creator><creator>Mirgh, Sumeet</creator><creator>Nayak, Lingaraj</creator><creator>Bonda, Avinash</creator><creator>Jindal, Nishant</creator><creator>Shirure, Vijay</creator><creator>Bagal, Bhausaheb</creator><creator>Mathew, Libin</creator><creator>Kannan, Sadhana</creator><creator>Saikia, Tapan</creator><creator>Khattry, Navin</creator><general>Springer India</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9520-795X</orcidid></search><sort><creationdate>20230101</creationdate><title>Comparison of Outcomes of Donor Lymphocyte Infusions With or Without Lenalidomide in Patients with Hematological Malignancies Post Allogeneic HSCT</title><author>Punatar, Sachin ; 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Addition of immunomodulatory drugs to DLI may augment GVL effect. Use of lenalidomide with DLI to augment GVL has not been previously reported. This retrospective analysis was to compare the outcomes of DLI with or without lenalidomide. All consecutive patients who received DLI from 01/2010 through 01/2020 were included. DLIs were given without any immunosuppression. Lenalidomide, when used, was given continuously, starting with 1st or subsequent DLI. Patients who received lenalidomide were compared with those who did not. Event (hematological relapse or death) free survival (EFS) and overall survival (OS) were calculated from 1st DLI. Primary objective was to compare OS. Secondary objectives were EFS, CR rates, acute GVHD, lenalidomide toxicities and DLI related mortality (TRM). Total 61 patients received DLI—43 without and 18 with lenalidomide; all outcomes in the 2 groups were similar. There were 26 patients with HLA-A*24 and/or HLA-B*40. Among these, trend towards improvement in OS (median OS not reached vs. 8 months, 4 year OS was 62% vs. 32%,
p
= 0.1) and EFS (median 9 vs. 1 month, 4 year EFS 50% vs. 22%,
p
= 0.1) was seen with lenalidomide. Overall, there was no improvement in outcomes by adding lenalidomide to DLI. However, among patients with HLA*24 or B*40, there was a trend to improved survival with lenalidomide. Use of lenalidomide to augment the GVL effect of DLI warrants further exploration.</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>36699432</pmid><doi>10.1007/s12288-022-01545-x</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-9520-795X</orcidid></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SpringerNature Journals; PubMed Central |
| subjects | Blood & organ donations Blood cancer Blood Transfusion Medicine Clinical outcomes Hematology Human Genetics Immunotherapy Lymphocytes Medicine Medicine & Public Health Oncology Original Original Article Stem cell transplantation Targeted cancer therapy |
| title | Comparison of Outcomes of Donor Lymphocyte Infusions With or Without Lenalidomide in Patients with Hematological Malignancies Post Allogeneic HSCT |
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