Donor Lymphocyte Infusion: the plan

According to an important cancer centre in Florida, the optimum preparation for Donor Lymphocyte Infusion (DLI) [Anthony Nolan] [Cleveland Clinic] [AI-generated article] is four cycles of Venaza. Administration of four cycles has been shown to facilitate improvement from morphological to molecular remission, the ideal starting point for DLI.

Morphological remission is the minimum starting point for DLI. I have already achieved morphological remission based on the two Venaza cycles that I have been through since the relapse in February. So the plan is as follows:

1. 27 June to 2 July 2024 Third cycle of Venaza. 5 days of Aza injections and 7 days of Venetoclax [COMPLETE]
   

2. 5 to 9 August 2024 Fourth cycle of Venaza. 5 days of Aza injections and 7 days of Venetoclax [COMPLETE]
   

3. 1 October 2024 Appointment with consultant [COMPLETE]
   

4. 10 October 2024 First dose of DLI. 1 x 10^6 T-cells/kg [COMPLETE]
   

5. Monitor the impact of the first dose. If too much GvHD, then exit the procedure and rethink next steps. If too little GvHD, then exit the procedure and rethink next steps. If GvHD response is just right, then go to Step 6.
   

6. January - February 2025 Second dose of DLI. 5 x 10^6 T-cells/kg
   

7. Monitor the impact of the second dose. If too much GvHD, then exit the procedure and rethink next steps. If too little GvHD, then exit the procedure and rethink next steps. If GvHD response is just right, then go to Step 8.
   

8. April - May 2025 Third dose of DLI. 1 x 10^7 T-cells/kg If too much GvHD, then exit the procedure and rethink next steps. If too little GvHD, then exit the procedure and rethink next steps. If GvHD response is just right, then go to Step 9.
   

9. Ongoing monitoring of response to the three DLI doses. Is molecular remission achieved and maintained? Is a second transplant necesary, or is cure achieved based on DLI alone?