Clearance of Hematologic Malignancies by Allogeneic Cytokine-Induced Killer Cell or Donor Lymphocyte Infusions

•Compared with donor lymphocyte infusion (DLI), T cell dose was significantly increased with cytokine-induced killer (CIK) cell therapy.•T cell recovery was significantly improved after CIK cell therapy (P < .0001).•CIK cells are endowed with a reduced propensity to cause GVHD.•Compared with DLI,...

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Published in:Biology of blood and marrow transplantation 2019-07, Vol.25 (7), p.1281-1292
Main Authors: Merker, Michael, Salzmann-Manrique, Emilia, Katzki, Verena, Huenecke, Sabine, Bremm, Melanie, Bakhtiar, Shahrzad, Willasch, Andre, Jarisch, Andrea, Soerensen, Jan, Schulz, Ansgar, Meisel, Roland, Bug, Gesine, Bonig, Halvard, Klingebiel, Thomas, Bader, Peter, Rettinger, Eva
Format: Article
Language:English
Subjects:
Allogeneic cytokine-induced killer cells
Cellular therapy
Donor lymphocyte infusion
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Summary:•Compared with donor lymphocyte infusion (DLI), T cell dose was significantly increased with cytokine-induced killer (CIK) cell therapy.•T cell recovery was significantly improved after CIK cell therapy (P < .0001).•CIK cells are endowed with a reduced propensity to cause GVHD.•Compared with DLI, CIK cell therapy showed a significantly reduced 6-month calculated cumulative incidence of relapse.•CIK cell therapy may be a promising alternative to classic DLI when leukemia burden is low. 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.
ISSN:1083-8791
1523-6536
DOI:10.1016/j.bbmt.2019.03.004