与初始 T 细胞相比，记忆 T 选择细胞 (CD45RA-/RO ) 作为供体淋巴细胞输注时产生同种异体反应性和移植物抗宿主病 (GvHD) 的能力较差。本研究的目的是评估异基因造血细胞移植（HCT）后高剂量记忆（CD45RA-/RO）供体淋巴细胞输注（mDLI）的安全性和有效性。 mDLI 的适应症是“根据需要”和“作为预防性治疗方案”。 61 名被诊断患有恶性疾病 (82%) 和非恶性疾病 (18%) 的儿童接受了 241 mDLI。患者平均接受 3 次 mDLI 输注（范围 1-13），中位输注剂量为 1.35 × 107/kg CD45RO，其中包含 8.96 × 106/kg CD3 CD45RO 和 3.81 × 103/kg CD3 CD45RA。 7 名患者在 4% 的 mDLI 输注后出现新发 GvHD。在 mDLI 之前患有 GvHD 的患者中，3 名 II-IV 级急性 GvHD 患者在 6 次输注后病情恶化（11%）。 65% 的 mDLI 输注后巨细胞病毒病毒载量下降。整个队列的两年总生存率 (OS) 为 64%（95% CI 57%−72%）。对于接受预防性 mDLI 的患者，两年无复发死亡率为 10%（95% CI 9%−11%）。综上所述，大剂量mDLI是可行且安全的，即使对于活动性GvHD患者，发生严重GvHD的风险也相对较低。重要的是，mDLI 与积极作用相关，包括增强对 CMV 病毒血症的控制。版权所有 © 2024 国际细胞学会

Memory T selected cells (CD45RA-/RO+) as donor lymphocyte infusion are less capable of producing alloreactivity and graft versus host disease (GvHD) compared with naïve T cells. The objective of this study was to evaluate the safety and efficacy of high-dose memory (CD45RA-/RO+) donor lymphocyte infusion (mDLI) after allogeneic hematopoietic cell transplantation (HCT). Indications for mDLI were "as needed" and "as prophylactic regimen." Sixty-one children diagnosed with malignant (82%) and non-malignant diseases (18%) received 241 mDLIs. Patients received a median of three infusions (range 1‒13) of mDLI with a median infused dose of 1.35 × 107/kg CD45RO+ containing 8.96 × 106/kg CD3+CD45RO+ and 3.81 × 103/kg CD3+CD45RA+. De novo GvHD developed in 7 patients following 4% of the mDLI infusions. Among patients with GvHD before mDLI, this condition worsened following 6 infusions (11%) in the 3 patients with grade II-IV acute GvHD. A decrease in cytomegalovirus viral load followed 65% of mDLI infusions. Two-year overall survival (OS) for the total cohort was 64% (95% CI 57%‒72%). For patients receiving prophylactic mDLI, the two-year non-relapse mortality was 10% (95% CI 9%‒11%). In summary, high-dose mDLI is feasible and safe, with a relatively low risk of severe GvHD even in patients with active GvHD. Importantly, mDLI was associated with positive effects, including enhanced control of CMV viremia.Copyright © 2024 International Society for Cell & Gene Therapy. Published by Elsevier Inc. All rights reserved.