Dana-Farber Cancer Institute researchers have identified factors that determine whether donor lymphocyte infusion (DLI), a standard therapy for patients with acute myeloid leukemia (AML) who have relapsed after allogenic hematopoietic stem cell transplant, will successfully move the patient into remission. The team identified that a key cell type in the DLI product and features of the tumor microenvironment in patients both play a role.
The findings were published in Science Immunology.
Relapse of AML after stem cell transplant is a major challenge. There are few effective therapies, and patient outcomes after relapse are poor.”
Katie Maurer, MD, PhD, first author
For patients with AML, a stem cell transplant holds the potential for a cure. The goal of the transplant is to replace the patient’s hematopoietic stem cells – cells that rejuvenate supplies of blood and immune cells – with donor stem cells that are not cancerous. In addition, the donor cells also include active immune cells that can attack leukemia cells that remain in the patient after the transplant. This phenomenon is called the graft versus leukemia effect.
However, approximately one in three patients with AML relapse after allogenic stem cell transplant. DLI is a follow-on treatment that can help stave off or treat relapse. It involves an infusion of white blood cells, called lymphocytes, from the donor of the stem cell transplant into the patient.
DLI is successful in only about 15-20% of patients with AML. Further, exactly how the cells in the DLI product help move leukemia