Donor lymphocyte infusion (DLI)

 
Definition of Donor lymphocyte infusion
Donor lymphocyte infusion: (DLI) A cancer treatment in which lymphocytes from a bone marrow donor are infused into the person who received the original bone marrow transplant. The goal of donor lymphocyte infusion is to induce a remission of the cancer by a process called the graft-versus-tumor (GVT) effect. Donor lymphocyte infusion is basically meant to boost the GVT effect. The donor lymphocytes, which are T cells, attack and kill residual cancer cells. That is the strategy.
Donor lymphocyte infusion has mainly been used to treat relapsed chronic myelogenous leukemia (CML). Patients with relapsed acute leukemia, chronic lymphocytic leukemia (CLL), myelodysplasia (MDS), Hodgkin disease, non-Hodgkin lymphoma (NHL), and multiple myeloma have also been treated by donor leukocyte infusion.
Extract of http://www.medterms.com/script/main/art ... ekey=39474

Donor lymphocyte infusion
Formerly, the only treatment option that offered relapsed bone marrow transplant patients hope of a cure was another bone marrow transplant. However, the risk of serious, life-threatening complications after a second BMT is great. One strategy of managing relapse, donor leukocyte infusion, might eliminate the need for a second BMT in some patients.
Extract of http://en.wikipedia.org/wiki/Donor_lymphocyte_infusion

Donor lymphocyte infusions
The infusion of lymphocytes from the original marrow donor (donor lymphocyte infusions [DLI]) is remarkably effective in treating chronic myeloid leukemia in relapse after allogeneic stem cell transplantation. DLI are less effective in acute leukemia and other hematologic tumors, but the use of interleukin-2 in conjunction with DLI after allograft may increase the response rate. The use of DLI to treat certain solid tumors is under investigation. In contrast, the value of donor lymphocytes for treating infectious complications post-transplant and graft failure has been established. The major drawback of DLI remains graft-versus-host disease, but novel regimens of administration and/or selective manipulation of donor cells prior to infusion have reduced its incidence. Further progresses in this area will help to establish the role of nonmyeloablative conditioning for allografting.
Extract of http://journals.lww.com/co-hematology/A ... ons.7.aspx

Infusion of lymphocytes obtained from a donor immunised with the paraprotein idiotype as a treatment in a relapsed myelomaA 48-year-old patient with IgA k multiple myeloma received a BMT from his HLA-matched sibling. After transplantation, the disease relapsed. Melphalan therapy followed by reinfusion of haemopoietic blood stem cells collected from the patient led to the improvement of the clinical status, although mixed chimerism and an elevated serum IgA persisted. Successful donor immunisation against an immunogenic preparation of the recipient monoclonal protein was performed before the infusion of donor T lymphocytes (DLI) into the patient. Ten weeks after the lymphocyte infusions, no monoclonal band was evidenced and donor complete chimerism was detected. The patient did not develop GVHD. Once complete remission was achieved, the idiotype vaccine was administered to the patient. Nineteen months after DLI, the patient remains in remission
Extract of http://www.nature.com/bmt/journal/v25/n ... 2399a.html 
                http://www.ncbi.nlm.nih.gov/pubmed/10828874


Donor lymphocyte infusion for the treatment of leukemia relapse after HLA-mismatched/haploidentical T-cell-replete hematopoietic stem cell transplantation
Xiao-Jun Huang, Dai-Hong Liu, Kai-Yan Liu, Lan-Ping Xu, Huan Chen, Wei Han
Extract of  http://haematologica.org/cgi/content/full/92/3/414