NCCN Guidelines for Patients® | Myelodysplastic Syndromes
36 NCCN Guidelines for Patients ® : Myelodysplastic Syndromes, 2018 4 Cancer treatments Donor lymphocyte infusion Side effects of allogeneic HCT A side effect is an unhealthy or unpleasant physical or emotional condition caused by treatment. Common side effects of chemotherapy, which is given before the transplant, are described on page 32. You will likely feel tired and weak shortly after the transplant while waiting for the new blood stem cells to grow in the bone marrow. Allogeneic HCTs have a high risk of GVHD ( g raft- v ersus- h ost d isease). GVHD is when the donated cells see the cells in your body as foreign and attack them. The parts of the body most commonly damaged by GVHD are the skin, intestines, and liver. GVHD is a serious side effect that can cause the transplant to fail by stopping the donated blood stem cells from growing in your bone marrow. GVHD can happen within a few weeks after the transplant or much later. Your doctor may give you medicine that suppresses your immune system to try to prevent this side effect. Donor lymphocyte infusion DLI ( d onor l ymphocyte i nfusion) is a treatment in which the patient receives lymphocytes from the same person who donated blood stem cells for the HCT. A lymphocyte is a type of white blood cell that helps the body fight infections. The purpose of a DLI is to stimulate an immune response called the GVL effect. This treatment may be used for MDS that came back or progressed after an HCT. Possible side effects of a DLI are similar to those caused by an allogeneic HCT. Because this treatment starts an immune response in your body, you are at risk for GVHD. Some other side effects of a DLI are weakened (suppressed) bone marrow and an increased risk of infection.