Krause Daniela S, Van Etten Richard A
Center for Blood Research, Institute for Biomedical Research, Harvard Medical School, Boston, MA, USA.
Blood. 2004 Dec 15;104(13):4236-44. doi: 10.1182/blood-2004-06-2229. Epub 2004 Aug 12.
Donor leukocyte infusion (DLI) can induce graft-versus-leukemia (GvL) reactions in patients with chronic myeloid leukemia (CML) relapsing after allogeneic bone marrow transplantation (BMT), but the mechanisms of the antileukemic effect of DLI are unknown, and the procedure is complicated by graft-versus-host disease (GvHD) and graft failure. Here, we adapted a murine retroviral BMT model of Philadelphia(+) leukemia by combining allogeneic bone marrow (BM) from C57Bl/6 (H-2(b)) mice with BCR-ABL-transduced Balb/c (H-2(d)) BM, inducing mixed chimerism and myeloproliferative disease in recipients resembling relapse of CML following allogeneic BMT. Infusions of allogeneic splenocytes eliminated BCR-ABL-induced CML-like disease in the majority of mixed chimeras, with significant GvL effects mediated by both CD4(+) and CD4(-) cells. BCR-ABL-induced acute B-lymphoblastic leukemia was also eradicated by DLI in major histocompatibility complex (MHC)-mismatched chimeras. Most DLI-treated mice converted to full allogeneic chimerism but succumbed frequently to GvHD or graft failure. When MHC-matched B10.D2 (H-2(d)) mice were the allogeneic donors, CML-like disease was more resistant to DLI. These results suggest that depletion of CD8(+) cells from DLI could impair GvL against CML, while increased MHC disparity between donor and recipient may improve the responsiveness of Philadelphia(+) B-lymphoblastic leukemia to DLI.
供体白细胞输注(DLI)可在异基因骨髓移植(BMT)后复发的慢性粒细胞白血病(CML)患者中诱导移植物抗白血病(GvL)反应,但DLI抗白血病作用的机制尚不清楚,且该过程因移植物抗宿主病(GvHD)和移植物失败而变得复杂。在此,我们通过将来自C57Bl/6(H-2(b))小鼠的异基因骨髓(BM)与BCR-ABL转导的Balb/c(H-2(d))BM相结合,建立了一种费城(+)白血病的小鼠逆转录病毒BMT模型,在受体中诱导混合嵌合体和骨髓增殖性疾病,类似于异基因BMT后CML的复发。输注异基因脾细胞在大多数混合嵌合体中消除了BCR-ABL诱导的CML样疾病,CD4(+)和CD4(-)细胞均介导了显著的GvL效应。在主要组织相容性复合体(MHC)不匹配的嵌合体中,DLI也根除了BCR-ABL诱导的急性B淋巴细胞白血病。大多数接受DLI治疗的小鼠转变为完全异基因嵌合体,但经常死于GvHD或移植物失败。当MHC匹配的B10.D2(H-2(d))小鼠作为异基因供体时,CML样疾病对DLI更具抗性。这些结果表明,从DLI中去除CD8(+)细胞可能会损害针对CML的GvL,而供体与受体之间MHC差异的增加可能会提高费城(+)B淋巴细胞白血病对DLI的反应性。