Graft-versus-leukemia reactions in allogeneic chimeras

摘要: There is a strong graft-versus-leukemia (GVL) effect of allogeneic stem cell transplantation (SCT) due to elimination tumor cells by alloimmune effector lymphocytes. When leukemia relapses after SCT, donor lymphocyte transfusions (DLTs) can induce sustained remissions in some patients. This review summarizes the current status on clinical use DLT, basis GVL reactions, problems associated with this therapy, and new strategies improve DLT. Several multicenter surveys demonstrated that DLT most effective chronic myelogenous (CML), whereas it less pronounced acute myeloma. Cytokine stimulation differentiation myeloid progenitor or up-regulate costimulatory molecules may efficacy Infections graft-versus-host disease (GVHD) are major complications Control GVHD be improved using suicide gene-modified T for allowing T-cell if severe develops. Hopefully, future, separated from through adoptive transfer selected recognize leukemia-specific antigens minor histocompatibility antigens, which expressed predominantly hematopoietic cells, thereby precluding attack normal tissues. In patients lymphomas fast progression, growth outpace development cells. Here preferable select transplant donors HLA-mismatches allow alloreactive natural killer appear early transplantation, retain their cytolytic function. New approaches immune therapy leukemia, promise better prognosis these patients, being developed.