[HTML][HTML] Clearance of hematologic malignancies by allogeneic cytokine-induced killer cell or donor lymphocyte infusions

M Merker, E Salzmann-Manrique, V Katzki… - Biology of Blood and …, 2019 - Elsevier
M Merker, E Salzmann-Manrique, V Katzki, S Huenecke, M Bremm, S Bakhtiar, A Willasch
Biology of Blood and Marrow Transplantation, 2019Elsevier
Well-established donor lymphocyte infusion (DLI) and novel cytokine-induced killer (CIK)
cell therapy for the treatment of relapsing hematologic malignancies after allogeneic
hematopoietic stem cell transplantation (HSCT) were compared with respect to feasibility,
safety, and efficacy. Altogether, a total of 221 infusions were given to 91 patients (DLI, n= 55;
CIK, n= 36). T cell recovery was significantly improved after CIK cell therapy (P<. 0001).
Although patients with CIK cell treatment showed a significantly worse prognosis at the time …
Abstract
Well-established donor lymphocyte infusion (DLI) and novel cytokine-induced killer (CIK) cell therapy for the treatment of relapsing hematologic malignancies after allogeneic hematopoietic stem cell transplantation (HSCT) were compared with respect to feasibility, safety, and efficacy. Altogether, a total of 221 infusions were given to 91 patients (DLI, n = 55; CIK, n = 36). T cell recovery was significantly improved after CIK cell therapy (P < .0001). Although patients with CIK cell treatment showed a significantly worse prognosis at the time of HSCT (risk score, 1.7 versus 2.1; P < .0001), DLI and CIK cell therapy induced complete remission (CR) in 29% and 53% patients, respectively, whereas relapse occurred in 71% and 47%. In both groups, all patients with overt hematologic relapse at the time of immunotherapy (DLI, n = 11; CIK, n = 8) succumbed to their disease, while 36% and 68% patients with DLI or CIK cell therapy applied due to molecular relapse or active disease at the time of transplantation achieved CR. The 6-month overall survival rate in the latter patients was 57% and 77%, respectively, with a median follow-up of 27.9 months (range, .9 to 149.2 months). The 6-month cumulative incidence of relapse was 55% and 22% in patients who received DLI and CIK cell therapy, respectively (P = .012). Acute graft-versus-host disease developed in 35% of the patients who received DLI and in 25% of those who received CIK. No transfusion-related deaths occurred. These data, while underscoring the therapeutic value of conventional DLI, suggest the improved safety and to a certain extent efficacy of CIK cell therapy for patients at high risk for post-transplantation relapse of various hematologic malignancies.
Elsevier