[HTML][HTML] Phase II study of sequential infusion of donor lymphocyte infusion and cytokine-induced killer cells for patients relapsed after allogeneic hematopoietic stem …

M Introna, F Lussana, A Algarotti, E Gotti… - Biology of Blood and …, 2017 - Elsevier
M Introna, F Lussana, A Algarotti, E Gotti, R Valgardsdottir, C Micò, A Grassi, C Pavoni…
Biology of Blood and Marrow Transplantation, 2017Elsevier
Seventy-four patients who relapsed after allogeneic stem cell transplantation were enrolled
in a phase IIA study and treated with the sequential infusion of donor lymphocyte infusion
(DLI) followed by cytokine-induced killer (CIK) cells. Seventy-three patients were available
for the intention to treat analysis. At least 1 infusion of CIK cells was given to 59 patients,
whereas 43 patients received the complete cell therapy planned (58%). Overall, 12 patients
(16%) developed acute graft-versus-host disease (aGVHD) of grades I to II in 7 cases and …
Abstract
Seventy-four patients who relapsed after allogeneic stem cell transplantation were enrolled in a phase IIA study and treated with the sequential infusion of donor lymphocyte infusion (DLI) followed by cytokine-induced killer (CIK) cells. Seventy-three patients were available for the intention to treat analysis. At least 1 infusion of CIK cells was given to 59 patients, whereas 43 patients received the complete cell therapy planned (58%). Overall, 12 patients (16%) developed acute graft-versus-host disease (aGVHD) of grades I to II in 7 cases and grades III to IV in 5). In 8 of 12 cases, aGVHD developed during DLI treatment, leading to interruption of the cellular program in 3 patients, whereas in the remaining 5 cases aGVHD was controlled by steroids treatment, thus allowing the subsequent planned administration of CIK cells. Chronic GVHD (cGVHD) was observed in 11 patients (15%). A complete response was observed in 19 (26%), partial response in 3 (4%), stable disease in 8 (11%), early death in 2 (3%), and disease progression in 41 (56%). At 1 and 3 years, rates of progression-free survival were 31% and 29%, whereas rates of overall survival were 51% and 40%, respectively. By multivariate analysis, the type of relapse, the presence of cGVHD, and a short (<6 months) time from allogeneic hematopoietic stem cell transplantation to relapse were the significant predictors of survival. In conclusion, a low incidence of GVHD is observed after the sequential administration of DLI and CIK cells, and disease control can be achieved mostly after a cytogenetic or molecular relapse.
Elsevier