Expanded Use of Donor Lymphocyte Infusion (DLI)

Please note: AABB reserves the right to make updates to this program.

Live Program Date: Thursday, March 30, 2017 - On-Demand Available

Master Program Number: 17EL-123 (see program format numbers below under Registration)

Educational Track: Technical/Clinical
Topic: Cellular Therapies
Intended Audience: Physicians, Scientists, Technologists, Nurses, Managers/Supervisors, Laboratory Staff, Medical Directors, Students/Fellows, Residents
Teaching Level: Intermediate, Advanced

Director/Moderator: Pampee P. Young, MD, PhD, Associate Professor, Medical Director, Transfusion Service, Vanderbilt Medical Center and Department of Veterans Affairs, Nashville, TN
Speakers: Mike Byrne, MD, Instructor, Vanderbilt University Medical Center, Nashville, TN; Pampee P. Young, MD, PhD, Associate Professor, Medical Director, Transfusion Service, Vanderbilt Medical Center and Department of Veterans Affairs, Nashville, TN

Learning Objectives

After participating in this educational activity, participants should be able to:

  • Identify the uses of Donor Lymphocytes.
  • Describe how are Donor Lymphocytes are manufactured.
  • Discuss changes in cell processing considerations.
  • Identify new Indications or uses of Donor Lymphocytes.
  • Describe adverse effects of Donor Lymphocytes.

Program Description

Donor lymphocyte infusion (DLI) was primarily used to treat and prevent relapse. More recently, DLIs are increasingly being used in both myeloablative and non-myeloablative stem cell transplantation to establish full donor chimerism and to treat and prevent infections. Moreover, DLI was typically administered as a single, large dose of lymphocytes (called a bulk dose regimen of ~2x108 CD3 cells); however, recent practices support lower doses to reduce incidences of GVHD. The doses suggested for modulating engraftment and preventing infections also tend to be lower. Thus, many centers have begun to transfuse donor lymphocytes in multiple aliquots, starting at low CD3 cell numbers and escalating the dosage at variable intervals as required (105, 106 vs. 107 CD3 cells per kg, Blood, 2000, 95:67). These changes have resulted in inconsistent and highly variable practices among transplant physicians within our institution with regard to both the number and size of requested cryopreserved doses. The resultant increases in the numbers of doses being cryopreserved (often more than 10 aliquots per patient), if not utilized, have the potential to unnecessarily increase the cost of long term storage of DLI products.


   Program #
Single Viewer: On-Demand Register17EL-4070-123
Group Viewing: On-Demand Register17EL-8070-123

Speaker Biographies

Dr. Michael Byrne is an assistant professor of medicine at Vanderbilt University Medical Center. He trained at the University of California San Francisco as an advanced fellow in adult Hematologic Malignancies and Blood & Marrow Transplantation. He is an active member of the Center for International Blood and Marrow Transplant Research, regularly reviews for the journals Bone Marrow Transplantation and Biology of Blood and Marrow Transplantation, and has authored over 30 manuscripts and book chapters. Dr. Byrne’s academic interest is in improving the care of patients with high-risk myeloid neoplasms and in the management of post-hematopoietic cell transplantation relapse.

Dr. Pampee Young is an Associate Professor of Pathology at Vanderbilt University Medical Center and Director of the Transfusion Service and Stem Cell Laboratory at Vanderbilt Medical Center and the adjoining Department of Veterans Affairs. Her laboratory’s basic research is focused on the study of stem cells in wound and cardiac repair and regeneration. Dr. Young has an active collaboration with stem cell and cardiovascular scientists at Vanderbilt to perform clinical cell therapy trials using bone marrow stem cells. In addition, she is also actively engaged in clinical and translational research in Transfusion Medicine. Her recent projects and publications include studies on transfusion safety, massive transfusion protocols, and loxocelism.