ArticleFrontiers in pharmacology2025
Donor lymphocyte infusion combined with azacitidine after allogeneic HSCT in pediatric AML: a single-center retrospective analysis.
Article in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Genomic Profiling, Induction Response, and Transplant Outcomes in Pediatric Acute Myeloid Leukemia: A Single-Center Retrospective Cohort Study.International journal of molecular sciences · 2026Article
- Donor lymphocyte infusion as immune modulation after pediatric allogeneic transplantation.Blood immunology & cellular therapy · 2026Article
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Authors and funding
12 authors.
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Abstract
Introduction: Donor lymphocyte infusion (DLI) can enhance graft-versus-leukemia (GvL) effects following allogeneic hematopoietic stem cell transplantation (HSCT) in pediatric acute myeloid leukemia (AML). However, the optimal integration of azacitidine (Aza) with DLI in children remains uncertain. Methods: We retrospectively analyzed 16 pediatric AML patients (≤18 years) treated at Fundeni Clinical Institute between 2016 and 2024 who received DLI in combination with azacitidine (75 mg/m Results: After a median follow-up of 46.5 months, five patients received prophylactic/preemptive DLI and eleven received therapeutic DLI (seven with chemotherapy, four without). All patients in the prophylactic/preemptive group achieved full donor chimerism and MRD negativity, with an OS of 80% at 2.7 years. In the therapeutic group, median OS was 23.8 months with chemotherapy and 13.8 months without. OS differences between groups were not statistically significant (p = 0.384). Acute GVHD occurred in two patients (12.5%) in the therapeutic + chemotherapy subgroup; no chronic GVHD or non-relapse mortality was observed. Conclusion: Azacitidine combined with DLI is feasible and safe in pediatric AML after HSCT, particularly when applied prophylactically or preemptively to restore donor chimerism or eradicate MRD. Therapeutic use in overt relapse remains challenging and provides limited benefit. Prospective multicenter studies are needed to define optimal timing, dosing, and combination strategies for integrating azacitidine with DLI in this high-risk pediatric population.
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