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Achieving donor chimerism or GVHD after infusion boosted survival only in relapse cases without prior GVHD, revealing a key window for GVL benefit.  

Researchers conducted a retrospective study published in June 2025 issue of British Journal of Haematology to examine whether prior graft-versus-host disease (GVHD) influenced the impact of donor lymphocyte infusion (DLI) on full donor chimerism (FDC) and subsequent GVHD after allogeneic stem cell transplantation (alloHSCT) relapse.  

They assessed 56 individuals who underwent DLI for relapse following alloHSCT between 2015 and 2022. Among these, 29 individuals had no prior history of GVHD before receiving DLI and the association of FDC and post-DLI GVHD was analyzed with overall survival (OS) within subgroups defined by prior GVHD status. Survival outcomes were compared using statistical analyses, and 1-year OS rates were calculated for different clinical scenarios.  

The results showed that among 29 individuals without prior GVHD before DLI, those who achieved FDC had a higher 1-year OS rate compared to those who did not (73.7% vs 20.0%; P< 0.001). In the same group, the development of GVHD after DLI was associated with a trend toward improved OS (60.0% vs 52.6%; P= 0.067). Among individuals with a history of GVHD before DLI, no statistically significant difference in OS was found between those with or without FDC (64.3% vs 33.3%; P= 0.226) or between those who developed GVHD post-DLI and those who did not (60.0% vs 53.3%; P= 0.866).  

Investigators concluded that FDC or post-infusion GVHD improved OS only in individuals without prior to GVHD, suggesting enhanced graft-versus-leukemia benefit. 

Source: onlinelibrary.wiley.com/doi/10.1111/bjh.20215