Pre-DLI or Pro-DLI in Relapsed/Refractory Myeloid Neoplasms After HSCT

Inclusion Criteria: * Eligible patients were those who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) for myeloid neoplasms (MN), excluding Philadelphia chromosome-positive (Ph+) disease, regardless of age. MN included acute myeloid leukemia (AML) and myelodysplastic syndrome with increased blasts (MDS-IB). Patients were required to have refractory or relapsed disease at the time of transplantation, defined as \>5% blasts in the bone marrow after salvage chemotherapy and prior to the transplant conditioning regimen. Additionally, patients must have achieved minimal residual disease (MRD)-negative remission within 1 month post-transplantation. All participants provided voluntary written informed consent. Exclusion Criteria: * Early mortality or relapse within 30 days post-transplantation. * Active graft-versus-host disease (GVHD) not under control between 30 and 60 days post-transplantation. * Presence of severe or uncontrolled infections. * Presence of significant organ dysfunction, defined as: Hepatic dysfunction: Known severe cirrhosis, portal hypertension, or active liver disease; or laboratory-confirmed alanine aminotransferase (ALT) or aspartate aminotransferase (AST) \> 3.0 × the upper limit of normal (ULN) and/or total bilirubin (TBIL) \> 1.5 × ULN. Renal dysfunction: Estimated glomerular filtration rate (eGFR) \< 60 mL/min/1.73m² (calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation) or serum creatinine \> 1.5 × ULN; or requirement for regular hemodialysis or peritoneal dialysis. Cardiac dysfunction: New York Heart Association (NYHA) functional class III or IV; unstable angina, acute myocardial infarction, coronary artery bypass grafting (CABG), or percutaneous coronary intervention (PCI) within 6 months prior to enrollment; left ventricular ejection fraction (LVEF) \< 50% (confirmed by echocardiography or other Doppler examination); clinically significant, uncontrolled arrhythmia. Respiratory dysfunction: Chronic obstructive pulmonary disease (COPD) or other pulmonary disease requiring long-term oxygen therapy; resting oxygen saturation (SpO₂) \< 92% on room air. * Participation in another investigational drug trial within the 3 months prior to enrollment. * Any other condition deemed by the investigator to make the patient unsuitable for the study.