Graft-versus-leukemia reactions in clinical bone marrow transplantation.
Immunologic reactions occurring after allogeneic bone marrow transplantation, known as graft-versus-leukemia effect, contribute significantly to the control of minimal residual disease and decreased risk of relapse post-transplant. Graft-versus-leukemia reactions occur with or without graft-versus-host disease and are either mediated through T-cells or are independent of T-cells. The contribution made by graft-versus-leukemia reactions to improvement in overall survival depends upon the underlying type of leukemia, the nature of the marrow graft and the morbidity of any associated graft-versus-host disease. This article reviews the evidence demonstrating graft-versus-leukemia effect in clinical bone marrow transplantation, some approaches to dissociate graft-versus-leukemia from graft-versus-host disease, and attempts to induce graft-versus-leukemia reactions in the setting of autologous bone marrow transplantation by immunotherapy.
Mehta
J
J
Leukaemia Unit, Royal Marsden Hospital, Surrey, England, UK.
D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000276:immunology; D006086:Graft vs Host Disease; D006087:Graft vs Host Reaction / Q000276:immunology; D006801:Humans; D007167:Immunotherapy; D007938:Leukemia / Q000628:therapy*; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D012008:Recurrence; D014181:Transplantation Immunology