Donor lymphocyte infusions in adolescents and young adults for control of advanced pediatric sarcoma

Sebastian J. Schober, Irene von Luettichau, Angela Wawer, Maximilian Steinhauser, Christoph Salat, Wolfgang Schwinger, Marek Ussowicz, Petar Antunovic, Luca Castagna, Hans Jochem Kolb, Stefan E.G. Burdach, Uwe Thiel

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background: Allogeneic stem cell transplantation (allo-SCT) and donor lymphocyte infusions (DLI) may induce a graft-versus-tumor effect in pediatric sarcoma patients. Here, we describe general feasibility, toxicity and efficacy of DLI after allo-SCT. Results: 4 of 8 patients responded. ES#4 had stable disease (SD) for 9 months after DLI and RMS#4 partial response for 8 months with combined hyperthermia/ chemotherapy. In ES#4, DLI led to SD for 6 months and reverted residual disease before allo-SCT into complete remission. After DLI, ES#4 and RMS#4 developed acute GvHD (°III-°IV), ES#4 also developed chronic GvHD. 5 patients including ES#4 lived longer than expected. Median survival after allo-SCT was 2.3 years, post-relapse survival (PRS) was 13 months. Off note, HLA-mismatched DLI were associated with a trend towards increased survival after allo-SCT and increased PRS compared to HLA-matched DLI (23 versus 3 months). Materials and Methods: We studied eight adolescents and young adults (AYAs) with advanced Ewing sarcoma (ES#1-4) and rhabdomyosarcoma (RMS#1-4) who received DLI. Escalating doses ranged from 2.5 x 104 to 1 x 108 CD3+ cells/kg body weight. AYAs were evaluated for response to DLI, graft-versus-host disease (GvHD) and survival. Conclusions: DLI after allo-SCT may control advanced pediatric sarcoma in AYAs with controllable toxicity.

Original languageEnglish
Pages (from-to)22741-22748
Number of pages8
JournalOncotarget
Volume9
Issue number32
DOIs
StatePublished - 27 Apr 2018
Externally publishedYes

Keywords

  • Allogeneic stem cell transplantation
  • Alloimmunity and transplantation
  • Donor lymphocyte infusion
  • Ewing sarcoma
  • Rhabdomyosarcoma

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