Evidence map›Paper›PMID 31368194›Full record

ArticlePediatric blood & cancer2019

Single-center experience suggests donor lymphocyte infusion may promote long-term survival in children with high-risk acute lymphoblastic leukemia.

Nicole Liberio, Haley Robinson, Melodee Nugent, Pippa Simpson, David A Margolis, Subramaniam Malarkannan, Carolyn Keever-Taylor, Monica S Thakar

Open access · greenAbstract readEvaluation Study
In one paragraph

Article in Pediatric blood & cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Nicole LiberioDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
Haley RobinsonDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
Melodee NugentDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
Pippa SimpsonDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
David A MargolisDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
Subramaniam MalarkannanDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
Carolyn Keever-TaylorDepartment of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
Monica S ThakarDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.ORCID 0000-0001-5801-5457
Medical College of Wisconsin · US

Funding

Molecular signature of inflammationR01CA179363 · NCI · MEDICAL COLLEGE OF WISCONSIN · PI MALARKANNAN, SUBRAMANIAM · 2014 to 2018
$1.6M
Molecular mechanisms of signaling co-ordination in innate lymphocytesR01AI102893 · NIAID · MEDICAL COLLEGE OF WISCONSIN · PI MALARKANNAN, SUBRAMANIAM · 2013 to 2016
$1.5M
NCI NIH HHS R01 CA179363NIAID NIH HHS R01 AI102893
6 · The paper itself

Abstract

backgroundDonor lymphocyte infusion (DLI) is often used to treat leukemic relapse after hematopoietic cell transplantation (HCT). However, the relationship between outcomes and distinct DLI cellular composition has not been previously reported. Additionally, there are limited published data on efficacy in pediatrics. We evaluated whether DLI cellular content and development of graft-versus-host disease (GVHD) impacted disease and influenced overall survival (OS) in children receiving DLI for recurrent leukemia.

methodsWe performed an Institutional Review Board-approved, retrospective study investigating all consecutive DLIs given to patients at the Children's Hospital of Wisconsin between 1980 and 2018. Analyses were conducted using Mann-Whitney, Fisher exact, and chi-square tests.

resultsThirty patients ≤20 years old with hematologic malignancies (myeloid [AML/MDS/CML/JMML], n = 23; lymphoid [ALL], n = 7) received DLI to treat post-transplant relapse. We found no significant difference in OS or development of GVHD based on CD3, CD4, CD8, CD56, or CD19 DLI cellular composition. With a median follow-up of 0.69 (range, 0.04-16.61) years, OS at five years was 32% ± 9%.  The lymphoid group had a five-year survival rate at 71% ± 17% compared with the myeloid group at 22% ± 9%, although not statistically significant (P = 0.11).  The development of GVHD did not affect OS (P = 0.62).

conclusionHere, we report a single-center, long-term experience of pediatric DLIs. Surprisingly, many children with ALL were able to achieve durable remissions. Although cellular composition did not have a significant effect on GVHD or OS in our small study, engineering DLI products to maximize specific effector cell populations could be one strategy to improve efficacy.

Indexed as

Lymphocyte TransfusionSalvage TherapyAdolescentChildFemaleFollow-Up StudiesGraft vs Leukemia EffectHematopoietic Stem Cell TransplantationHumansKaplan-Meier EstimateLeukemia, Myeloid, AcuteMaleMyelodysplastic SyndromesPrecursor Cell Lymphoblastic Leukemia-LymphomaRecurrenceRetrospective Studiesbone marrow transplantdonor lymphocyte infusionimmunotherapyleukemiapediatrics

Identifiers

PMID31368194
PMCPMC6754268
OpenAlexW2965518929

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.