The cell composition of infused donor lymphocyte has different impact in different types of allogeneic hematopoietic stem cell transplantation

Abstract

Donor lymphocyte infusion (DLI) is often used to enhance the graft-versus-leukemia (GVL) effect after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In this study, we first evaluated the impact of the cell composition of a modified DLI (mDLI) on the prognoses of patients. A total of 194 patients undergoing allo-HSCT were enrolled and received mDLI for various clinical reasons. The infused cellular components of the mDLI were examined by flow cytometry. The results showed that infusion with a lower dose of CD14+ cells (<0.33 × 108/kg) was an independent risk factor for the occurrence of II-IV acute graft-versus-host disease (aGVHD) (HR = 0.104, p = 0.032) in human leukoctye antigen-identical transplant patients. In addition, a dose of CD14+ cells greater than the 50th percentile was associated with a lower incidence of hematological relapse and longer disease-free survival (DFS) after the mDLI (relapse: HR = 0.193, p = 0.007; DFS: HR = 0.259, p = 0.016). However, we also found that a greater number of CD14+ cells were an independent risk factor for II-IV aGVHD (HR = 1.758, p = 0.034) in haploidentical allo-HSCT. In conclusion, our data were the first to demonstrate that the cell composition of a 56 mDLI played a distinct role in different types of allo-HSCT. This finding provided a novel approach for the development of cellular therapies by manipulating the components of infused cells. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.