LAUSR

Allogeneic hematopoietic cell transplant (alloHCT) represents a significant therapeutic approach for patients diagnosed with lymphoid malignancies (LM). However, relapse remains a major cause of treatment failure. In this scenario, a number of strategies have been adopted with the aim of enhancing the T-cell compartment. A second alloHCT (HCT2) or donor lymphocyte infusions (DLI) represent two major approaches at this point. Outcomes after DLI in LM have been mostly reported within T-cell depleted (TCD) reduced intensity (RIC) transplant platforms [1, 2], in which mixed T-cell chimeras (MC) are frequent and lower graftversus-host disease (GvHD) rates provide a higher chance to receive DLI. On the contrary, T-cell replete (TCR) alloHCT associates an early donor T-cell expansion, MC are infrequent, and GvHD rates are higher, which may refrain the physician from administering DLI. DLI for LM relapse after TCR alloHCT has not been studied specifically and in depth, and needs further exploration. Hence, we conducted a retrospective multicenter study to determine the clinical features in multiple relapsed or refractory LM patients (mainly B-cell malignancies) treated with DLI after TCR alloHCT. All patients signed informed consent according to the Helsinki rules and institutional ethics committee. The inclusion criteria were (1) diagnosis of lymphoma, chronic lymphoid leukemia (CLL), or multiple myeloma (MM), (2) hematological or morphological relapse, and (3) to receive DLI as treatment. The exclusion criteria were (1) the use of T-cell depletion, (2) HCT2 prior to DLI, and (3) preemptive or prophylactic DLI. The disease diagnosis was confirmed in all patients based upon the World Health Organization classification. Disease status, response, and progression were assessed according to international guidelines and recommendations [3–5]. OS univariate and multivariate analysis were performed, p value < 0.05 was considered statistically significant, and variables with a p value < 0.1 were included in multivariate analysis. The analysis was performed from the first DLI date. A competing-risk and descriptive GvHD analysis were performed. The clinical manifestations of acute GvHD (aGvHD) and chronic GvHD (cGvHD) were graded according to the Keystone 1994 consensus criteria [6] and the historical criteria [7]. Forty-three patients (17 women) were included. Diagnoses were as follows: 19 (44%) MM, 12 (28%) Hodgkin’s Corrected: Correction