Prophylactic donor lymphocyte infusions after first allogeneic hematopoietic stem cell transplantation in children with acute leukemia

Sep 30, 2026

Upload by Mia

Purpose: assess the feasibility and safety of prophylactic donor lymphocyte infusion (DLI) after allogeneic hematopoietic stem cell transplantation (HSCT) to enhance survival in pediatric acute leukemia. Methods: retrospectively analyze children receiving prophylactic DLI after allo-HSCT from October 2015 to October 2024. Results: 101 patients included, with post-DLI GVHD in 46.53%; most cases were mild and severe GVHD occurred in five. Five-year OS 88.74% and EFS 79.66%; higher cumulative DLI dose (>4.75×10^7/kg) correlated with favorable prognosis. Conclusion: prophylactic DLI remains safe and effective, reducing relapse risk and supporting long-term survival.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Purpose

Methods

Results

Conclusion

Introduction

Methods

Patients

Wei et al. Blood Research (2026) 61:1 [https://doi.org/10.1007/s44313-025-001](https://doi.org/10.1007/s44313-025-001)11-4 Blood Research RESEARCH Open Access Prophylactic donor lymphocyte infusions after first allogeneic hematopoietic stem cell transplantation in children with acute leukemia Ang Wei1,2,3,4,5†, Chenguang Jia1,2,3,4,5†, Guanghua Zhu1,2,3,4,5, Jun Yang1,2,3,4,5, Jie Zheng1,2,3,4,5, Yuanfang Jing1,2,3,4,5, Meng Zhang1,2,3,4,5, Lixiao Cai6,7, Ying Han6,7, Ximu Sun 1,2,3,4,5, Chenzhuo Shu1,2,3,4,5, Wei Chen1,2,3,4,5, Maoquan Qin1,2,3,4,5*, Bin Wang1,2,3,4,5* and Yanhui Luo 1,2,3,4,5* Abstract Purpose To evaluate the feasibility and safety of prophylactic donor lymphocyte infusion (DLI) following allogeneichematopoietic stem cell transplantation (HSCT) to improve survival outcomes in pediatric patients with acute leukemia (AL) . Methods Children with AL who received prophylactic DLI transfusion after allogeneic HSCT between October 2015 and October 2024 were retrospectively analyzed. Results In total, 101 pediatric patients with AL were enrolled in this study, comprising 42 acute lymphoblastic leukemia, 54 acute myeloid leukemia, and five mixed-phenotype acute leukemia cases. The median age at transplantation was 7.52 ± 3.98 years. The median time from HSCT to first DLI was 306.26 days (range 51 .00–1016. 00) . Patients received a median cumulative dose of 5.00 × 10⁷/kg (0 .50–36. 20) . Post-DLI GVHD occurred in 46. 53% of cases. Most events were mild; severe GVHD occurred in only five cases. After prophylactic DLI transfusion, the 5-year overall survival (OS) and event-free survival (EFS) rates were 88. 74% ± 3 . 70% and 79. 66% ± 4 . 92%, respectively. The difference of the OSand EFS in patients with GVHD and without GVHD after prophylactic DLI transfusion were not statistically significant (χ2 = 0 . 39, P = 0.53 and χ2 = 0 . 98, P = 0 . 32) . Cumulative DLI dose > 4.75 × 10⁷/kg was associated with favorable prognosis (Area under the curve 0 . 67, 95% confidence interval 0.50–0. 83, P = 0 . 03) . Conclusion Prophylactic DLI transfusion following allogeneic HSCT remains a safe and effective treatment for pediatric patients with AL and can reduce post-transplant relapse and improve long-term survival. Keywords Prophylactic donor lymphocyte infusion, Hematopoietic stem cell transplantation, Prognosis, Graft versus host disease, Acute leukemia †Ang Wei and Chenguang Jia contributed equally as co-first authors. *Correspondence: Maoquan Qin [qinmq3966@qq.com](qinmq3966@qq.com)[ ](qinmq3966@qq.com)Bin Wang [wbin@medmail.com.cn](wbin@medmail.com.cn)[ ](wbin@medmail.com.cn)Yanhui Luo [luoyh0825@163.com](luoyh0825@163.com) Full list of author information is available at the end of the article © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/.)[.](http://creativecommons.org/licenses/by-nc-nd/4.0/.) Wei et al. Blood Research (2026) 61:1 Introduction Allogeneic hem

FAQs

What is the purpose of prophylactic donor lymphocyte infusion after HSCT in this study?

To evaluate feasibility and safety, and to determine whether prophylactic DLI can improve survival outcomes in children with acute leukemia.

How was the study designed and who were the participants?

This retrospective observational study enrolled children with acute leukemia who received prophylactic DLI after allogeneic HSCT between October 2015 and October 2024.

What were the key outcomes related to survival and GVHD?

Post-DLI GVHD occurred in 46.53% of cases, mostly mild, with severe GVHD in five cases. After prophylactic DLI, 5-year overall survival was 88.74% and event-free survival was 79.66%.

Sep 30, 2026

Upload by Mia