Escalating-dose HLA-mismatched DLI is safe for the treatment of leukaemia relapse following alemtuzumab-based myeloablative allo-SCT

Bone Marrow Transplant. 2013 Oct;48(10):1324-8. doi: 10.1038/bmt.2013.69. Epub 2013 May 20.


Although the feasibility of using HLA-mismatched unrelated donors as an alternate graft source for haematopoietic SCT (HSCT) has been shown, little is known about the safety of HLA-mismatched DLI for the treatment of relapse. We examined the outcome of 58 consecutive leukaemia patients who received escalating-dose DLI for treatment of relapse after alemtuzumab-conditioned myeloablative unrelated donor HSCT at our institution. High-resolution HLA typing on stored DNA samples revealed mismatches in 28/58 patients who were considered HLA-matched at the time of transplantation. Following DLI from HLA-matched (10/10) (n=30) or -mismatched (7-9/10) (n=28) unrelated donors, we found no significant difference in the incidence of acute GVHD (17.2% versus 23.1%, P=0.59), probability of remission at 3 years (62.1% versus 63.9%, P=0.89) or 5-year OS (89.8% versus 77.7%, P=0.22). We conclude that escalating-dose DLI can be safely given to HLA-mismatched recipients following T-depleted myeloablative HSCT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Alemtuzumab
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Female
  • HLA Antigens / immunology*
  • Histocompatibility / immunology
  • Humans
  • Leukemia / drug therapy
  • Leukemia / immunology
  • Leukemia / surgery
  • Leukemia / therapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / immunology
  • Neoplasm Recurrence, Local / therapy
  • Retrospective Studies
  • Stem Cell Transplantation / methods*
  • T-Lymphocytes / immunology
  • T-Lymphocytes / transplantation*
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult


  • Antibodies, Monoclonal, Humanized
  • HLA Antigens
  • Alemtuzumab