Interferon-α salvage treatment is effective for patients with acute leukemia/myelodysplastic syndrome with unsatisfactory response to minimal residual disease-directed donor lymphocyte infusion after allogeneic hematopoietic stem cell transplantation

Abstract

The efficacy of salvage interferon-α (IFN-α) treatment was investigated in patients with unsatisfactory response to minimal residual disease (MRD)-directed donor lymphocyte infusion (DLI) (n=24). Patients who did not become MRD-negative at 1 month after DLI were those with unsatisfactory response and were eligible to receive salvage IFN-α treatment within 3 months of DLI. Recombinant human IFN-α-2b injections were subcutaneously administered 2–3 times a week for 6 months. Nine (37.5%), 6 (25.0%), and 3 (12.5%) patients became MRD-negative at 1, 2, and>2 months after the salvage IFN-α treatment, respectively. Two-year cumulative incidences of relapse and non-relapse mortality were 35.9% and 8.3%, respectively. Two-year probabilities of event-free survival, disease-free survival, and overall survival were 51.6%, 54.3%, and 68.0%, respectively. Outcomes of patients subjected to salvage IFN-α treatment after DLI were significantly better than those with persistent MRD without IFN-α treatment. Moreover, clinical outcomes were comparable between the salvage DLI and IFN-α treatment groups. Thus, salvage IFN-α treatment may help improve the outcome of patients with unsatisfactory responses to MRD-directed DLI and could be a potential salvage treatment for these patients after allogeneic hematopoietic stem cell transplantation.

Keywords

interferon-α / hematopoietic stem cell transplantation / minimal residual disease / donor lymphocyte infusion

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Acknowledgements

The authors thank Drs. Dao-Xing Deng, Zhi-Hong Jiang, and Wei Guo for their assistance in collecting the data for this study. We also thank Wei Guo for her assistance in the writing of this manuscript. This work was supported by the National Natural Science Foundation of China (No. 81400145), the Beijing Talents Fund (No. 2015000021223ZK39), the Key Program of the National Natural Science Foundation of China (No. 81530046), Foundation for Innovative Research Groups of the National Natural Science Foundation of China (No. 81621001), and the Science and Technology Project of Guangdong Province of China (No. 2016B030230003).

Compliance with ethics guidelines

Xiaodong Mo, Xiaohui Zhang, Lanping Xu, Yu Wang, Chenhua Yan, Huan Chen, Yuhong Chen, Wei Han, Fengrong Wang, Jingzhi Wang, Kaiyan Liu, and Xiaojun Huang declare no potential financial conflict of interest related to this manuscript. Informed consent was obtained from all patients or the patients’ guardians. The study was conducted in accordance with the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of Peking University People’s Hospital.

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