Donor lymphocyte infusion following allogeneic hematopoietic stem cell transplantation.
BACKGROUND
Allogeneic hematopoietic stem cell transplantation (SCT) is the treatment of choice for many malignant hematological disorders. Following recent improvements in non-relapse-related mortality rates, relapse has become the commonest cause of treatment failure. Infusion of donor lymphocytes can potentially enhance immune-mediated antitumor activity and offers a salvage option for some patients. This paper reviews the current literature on the efficacy of this therapeutic strategy.


METHODS
The biology of adoptive cellular therapy with allogeneic immune cells to treat relapse across a spectrum of diseases in both the full intensity and reduced intensity hematopoietic SCT settings is explored. The review discusses the current limitations of the approach and reviews several new experimental strategies which aim to segregate the desired graft-versus-tumor effect from the deleterious effects of more widespread graft-versus-host reactivity.


CONCLUSIONS
Durable responses to DLI have been noted in chronic myeloid leukemia and responses have also been described in acute leukemia, multiple myeloma and chronic lymphoproliferative disorders. The new challenge in transplantation is to optimize DLI therapy in order to further improve patient outcomes.
UCL Cancer Institute, Department of Haematology, Paul O'Gorman Building, 72 Huntley Street, London, WC1E 6BT, UK.
Claire
C
Roddie
Karl S
KS
Peggs
D000328:Adult; D000818:Animals; D002648:Child; D006086:Graft vs Host Disease / Q000276:immunology / Q000517:prevention & control; D020350:Graft vs Tumor Effect; D019337:Hematologic Neoplasms / Q000266:history / Q000276:immunology / Q000601:surgery / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000266:history; D049673:History, 20th Century; D006801:Humans; D017710:Lymphocyte Transfusion / Q000009:adverse effects / Q000266:history; D018365:Neoplasm, Residual; D055502:Secondary Prevention; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D014019:Tissue Donors / Q000266:history; D014184:Transplantation, Homologous; D016896:Treatment Outcome