Graft-Versus-Host Disease after Prophylactic Donor Lymphocytes Infusion in Children with Acute Leukemia and JMML
Prophylactic donor lymphocytes infusion (DLI) is used in patients with a high risk of relapse after allo-HSCT. The data about safety of early start DLI in children are extremely limited. This study demonstrates the incidence of clinically significant graft versus host disease (GVHD) and correlation with overall and disease-free survival. We analyzed 37 children with acute leukemia and JMML, who had received prophylactic DLI within the first 6 months after HSCT. Moderate acute/chronic GVHD was diagnosed in 7/37 children (19%), nobody developed severe GVHD. The most children had chronic GVHD with involvement of skin and liver. There were no cases GVHD-related mortality. The induction of acute/chronic GVHD improved the relapse-free survival and did not influence on overall survival, p=0.04 and p=0.3, respectively.