Graft versus leukemia (GVL) in the therapy of acute lymphoblastic leukemia (ALL).
The ability of T cells that accompany or develop from transplanted allogeneic marrow to eradicate leukemia has been repeatedly demonstrated in animal models. Whether a similar graft-versus-leukemia effect exists in humans who have received transplants for acute lymphoblastic leukemia can be addressed by five different clinical observations: comparisons of autologous versus allogeneic transplantation, comparisons of syngeneic versus allogeneic transplantation, examination of relapse rates in allogeneic recipients who do or do not develop GVHD, the impact of T-cell depletion on relapse rates, and the results of donor lymphocyte infusions to treat posttransplant relapse. The bulk of available evidence supports the view that a potent GVL effect exists in patients treated for ALL. These results provide a strong rationale for efforts to develop techniques to further capitalize on the GVL effect.
Appelbaum
F R
FR
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98104, USA.
D016026:Bone Marrow Transplantation / Q000276:immunology*; D006086:Graft vs Host Disease; D006801:Humans; D008212:Lymphocyte Depletion; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D013601:T-Lymphocytes; D014184:Transplantation, Homologous; D014185:Transplantation, Isogeneic