Sosman J A, Sondel P M
Section of Hematology/Oncology, Stritch School of Medicine, Loyola University of Chicago, Maywood, IL 60153.
Bone Marrow Transplant. 1991;7 Suppl 1:33-7.
An anti-leukemic effect of allogeneic bone marrow has been repeatedly demonstrated in experimental animal models. Clinical data supporting this "graft versus leukemia" (GVL) effect are derived from several different observations which include: 1) the association of GVHD (acute and chronic) with decreased leukemic relapses; 2) identical twin transplants are associated with a higher relapse rate compared to allogeneic MHC-matched sibling transplants; 3) T cell depletion of donor bone marrow decreases GVHD and increases leukemic relapse rates; 4) Allogeneic BMT without GVHD have a lower leukemic relapse rate compared to identical twin transplants and T cell depleted transplants. The mechanisms of this GVL effect remain poorly understood, but clearly involve the immune system. It is hoped that current advances in basic understanding of the immune system and its activation will enable the "antileukemic" components of the GVL effect to be prospectively controlled and intentionally used as leukemia therapy.
在实验动物模型中，异基因骨髓的抗白血病作用已得到反复证实。支持这种“移植物抗白血病”（GVL）效应的临床数据来自几个不同的观察结果，其中包括：1）（急性和慢性）移植物抗宿主病（GVHD）与白血病复发减少相关；2）与异基因MHC匹配的同胞移植相比，同卵双胞胎移植的复发率更高；3）供体骨髓的T细胞清除可降低GVHD并增加白血病复发率；4）与同卵双胞胎移植和T细胞清除的移植相比，无GVHD的异基因骨髓移植（BMT）白血病复发率更低。这种GVL效应的机制仍知之甚少，但显然涉及免疫系统。人们希望，目前在免疫系统及其激活的基础理解方面取得的进展将使GVL效应的“抗白血病”成分能够得到前瞻性控制，并有意用作白血病治疗方法。
