Donor Lymphocyte Infusion
A donor lymphocyte infusion (DLI) is a procedure in which lymphocytes (a type of white blood cell) from a donor are given to the patient with blood cancer. DLI is a potential treatment option in people who have had a previous treatment with an allogeneic stem cell transplant. The lymphocytes come from the same donor who provided the stem cells for the transplant. The lymphocytes may be collected at the same time as the initial stem cells and saved for later use.1
When is donor lymphocyte infusion used after stem cell transplant?
DLI may be used to treat relapses of certain kinds of blood cancer in people who have previously had an allogeneic stem cell transplant. In some cases, DLI is used in combination with chemotherapy. DLI has been shown to be very effective in treating certain types of chronic myelogenous leukemia (CML). It may also be used to treat other blood cancers, including acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), multiple myeloma, and myelodysplastic syndromes (MDS).2,3
DLI may also be used to prevent a relapse of blood cancer by using the donor lymphocytes to treat the cancer. The donor's stem cells fight the blood cancer cells because they recognize them as foreign. This is called a "graft-versus-cancer" effect (graft refers to the donor's cells).2
How does donor lymphocyte infusion work?
The lymphocytes are taken from blood donated by the original stem cell transplant donor. This donation may be part of the original donation, or the donor may be contacted again. The lymphocytes are delivered similarly to a blood transfusion. The goal of the DLI is that the donor cells will attack any blood cancer cells and cause a remission of the cancer.3
Possible side effects of donor lymphocyte infusion
The predominant side effect of DLI is graft-versus-host disease (GVHD). GVHD is a condition in which the donor's cells see the patient's body as foreign and begin to attack certain organs in the patient's body. GVHD can range from mild to life-threatening and may affect various parts of the body, including the skin, liver, and intestines.2,3
Another possible DLI side effect is bone marrow suppression, in which fewer blood cells are produced by the bone marrow. This can potentially lead to low levels of white blood cells, red blood cells, or platelets. Most cases of bone marrow suppression are short-term and resolve themselves. Some people may be given medications to boost their blood cells or may receive blood transfusions.3