Is there a place for immunotherapy with interleukin-2 to prevent relapse after autologous stem cell transplantation for acute leukemia?
Chemotherapy-resistant cells cause disease recurrence in a significant proportion of patients with acute leukemia treated with autologous stem cell transplantation due to the lack of immune-mediated effects which contribute significantly to the prevention of post-treatment disease recurrence. This conclusion is based on the observation that relapse after high dose chemotherapy supported by a stem cell transplant from a twin donor is 3-4 times higher than after transplant from an allogeneic donor. This anti-leukemic mechanism of transplanted donor cells has been termed graft-versus-leukemia (GVL) effect, and efforts are being directed toward utilizing such an immune-mechanism after autologous transplantation. Since interleukin-2 (IL-2) can induce remissions in selected patients with advanced leukemia, it has become a candidate cytokine to be used in attempts to introduce GVL after autologous stem cell transplantation. Here we review the available clinical data with IL-2 and critically evaluate whether IL-2 has a place as adjunct treatment to prevent relapse after autologous transplantation for acute leukemia.
Klingemann
H G
HG
Leukemia/Bone Marrow Transplant Program of British Columbia, Vancouver Hospital and Health Sciences Center, Canada.
Phillips
G L
GL
D000206:Actuarial Analysis; D000208:Acute Disease; D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003602:Cytotoxicity, Immunologic / Q000187:drug effects; D018572:Disease-Free Survival; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D016219:Immunotherapy, Adoptive; D007376:Interleukin-2 / Q000494:pharmacology / Q000627:therapeutic use*; D007938:Leukemia / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D007942:Leukemia, Experimental / Q000628:therapy; D018365:Neoplasm, Residual; D051381:Rats; D011994:Recombinant Proteins / Q000627:therapeutic use; D012074:Remission Induction; D014181:Transplantation Immunology; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D007155:Immunologic Factors; D007376:Interleukin-2; D011994:Recombinant Proteins