Haematologica (Jan 2020)

Clinical applications of donor lymphocyte infusion from an HLA-haploidentical donor: consensus recommendations from the Acute Leukemia Working Party of the EBMT

  • Bhagirathbhai Dholaria,
  • Bipin N. Savani,
  • Myriam Labopin,
  • Leo Luznik,
  • Annalisa Ruggeri,
  • Stephan Mielke,
  • Monzr M. Al Malki,
  • Piyanuch Kongtim,
  • Ephraim Fuchs,
  • Xiao-Jun Huang,
  • Franco Locatelli,
  • Franco Aversa,
  • Luca Castagna,
  • Andrea Bacigalupo,
  • Massimo Martelli,
  • Didier Blaise,
  • Patrick Ben Soussan,
  • Yolande Arnault,
  • Rupert Handgretinger,
  • Denis-Claude Roy,
  • Paul O’Donnell,
  • Asad Bashey,
  • Scott Solomon,
  • Rizwan Romee,
  • Philippe Lewalle,
  • Jorge Gayoso,
  • Michael Maschan,
  • Hillard M. Lazarus,
  • Karen Ballen,
  • Sebastian Giebel,
  • Frederic Baron,
  • Fabio Ciceri,
  • Jordi Esteve,
  • Norbert-Claude Gorin,
  • Alexandros Spyridonidis,
  • Christoph Schmid,
  • Stefan O. Ciurea,
  • Arnon Nagler,
  • Mohamad Mohty

DOI
https://doi.org/10.3324/haematol.2019.219790
Journal volume & issue
Vol. 105, no. 1

Abstract

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Donor lymphocyte infusion has been used in the management of relapsed hematologic malignancies after allogeneic hematopoietic cell transplantation. It can eradicate minimal residual disease or be used to rescue a hematologic relapse, being able to induce durable remissions in a subset of patients. With the increased use of haploidentical hematopoietic cell transplantation, there is renewed interest in the use of donor lymphocytes to either treat or prevent disease relapse post transplant. Published retrospective and small prospective studies have shown encouraging results with therapeutic donor lymphocyte infusion in different haploidentical transplantation platforms. In this consensus paper, finalized on behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation, we summarize the available evidence on the use of donor lymphocyte infusion from haploidentical donor, and provide recommendations on its therapeutic, pre-emptive and prophylactic use in clinical practice.