Cellular Immunotherapy Outcomes Assessed in MDS With Relapse After Allogeneic HSCT

By Andrew Moreno - Last Updated: November 22, 2024

A single-center study has evaluated cellular immunotherapy in patients with myelodysplastic syndromes (MDS) who experienced relapse following allogeneic hematopoietic stem cell transplantation (HSCT). The study found this type of intervention brought better outcomes than non-cellular immunotherapy approaches and is published in Annals of Hematology.

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A team of researchers led by Gi-June Min, MD, PhD, from The Catholic University of Korea in Seoul, wrote that cellular immunotherapy produced more favorable outcomes whether patients had hematologic or pre-hematologic relapse. Moreover, such treatment was “particularly advantageous in pre-hematologic relapse cases with progression risk factors, while its benefits remained consistent in hematologic relapse cases.”

The study enrolled 149 patients with relapsed MDS who had undergone allogeneic HSCT. 87 patients had hematologic relapse, and 62 patients had pre-hematologic relapse. The pre-hematologic relapse sub-cohort included 28 patients with maximum donor chimerism of 95%, 17 patients with WT1 transcript greater than 250 copies/104ABL1, and 17 patients who had recurring chromosomal aberrations.

Among the patients with pre-hematologic relapse, the investigators estimated that the overall survival (OS) rate at four years from the time of relapse was 44.1%, which was significantly higher than the OS they calculated for patients with hematologic relapse.

The multivariate analysis found preemptive use of cellular immunotherapy, whether as a donor lymphocyte infusion or second allogenic HSCT, to be an independent factor in preventing hematologic relapse. It was especially effective in patients with a higher risk according to MDS transplantation prognostic scoring or who did not have chronic graft-versus-host disease.

Among patients with hematologic relapse, cellular immunotherapy produced markedly greater OS compared with non-cellular immunotherapy approaches.

Reference

Min GJ, Park SS, Park S, et al. Beneficial effects of cellular immunotherapy in the prevention and treatment of posttransplant hematologic relapse of myelodysplastic neoplasms. Ann Hematol. 2024. doi:10.1007/s00277-024-06060-9

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