T cell-mediated graft-versus-leukemia reactions after allogeneic stem cell transplantation.
Allogeneic hematopoietic stem cell transplantation represents the only curative approach for many hematological malignancies. During the last years the impact of the conditioning regimen has been re-assessed. With the advent of reduced-intensity conditioning the paradigm has changed from cytoreduction executed by high-dose radio-chemotherapy to immunological surveillance of leukemia by donor cells. Distinct subsets of T cells and NK cells contribute to graft-versus-leukemia reactions. So far, cytotoxic T lymphocytes are the mainstay of allogeneic immunotherapy. Here, we summarise the current knowledge of T cell-mediated graft-versus-leukemia reactions and present results from pre-clinical and clinical studies of T cell-based adoptive immunotherapy. We address the issues of feasibility and specificity of adoptive immunotransfer from a clinical point of view and discuss the prerequisites for successful clinical applications. Finally, the prospects for immunological research that have evolved with the increasing use of reduced-intensity conditioning and allogeneic stem cell transplantation are highlighted.
Schetelig
Johannes
J
Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307 Dresden, Germany. johannes.schetelig@uniklinikum-dresden.de
Kiani
Alexander
A
Schmitz
Marc
M
Ehninger
Gerhard
G
Bornhäuser
Martin
M
D000818:Animals; D000951:Antigens, Neoplasm / Q000276:immunology; D016044:Fusion Proteins, bcr-abl / Q000276:immunology; D020544:Graft vs Leukemia Effect / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016219:Immunotherapy, Adoptive; D007938:Leukemia / Q000276:immunology / Q000628:therapy*; D015778:Minor Histocompatibility Antigens / Q000032:analysis / Q000235:genetics / Q000276:immunology; D053146:Myeloblastin; D012697:Serine Endopeptidases / Q000276:immunology; D012730:Sex Chromosomes; D013601:T-Lymphocytes / Q000276:immunology*; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D014184:Transplantation, Homologous; D025721:WT1 Proteins / Q000276:immunology
D000951:Antigens, Neoplasm; D015778:Minor Histocompatibility Antigens; D025721:WT1 Proteins; D016044:Fusion Proteins, bcr-abl; D012697:Serine Endopeptidases; D053146:Myeloblastin