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[异基因干细胞移植后的供体淋巴细胞输注]

[Donor lymphocyte infusion after allogeneic stem cell transplantation].

作者信息

Schmid Christoph, Kolb Hans-Jochem

机构信息

Professur für Stammzell-Transplantation und Zelltherapieforschung, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland.

Kolb Consulting UG, München, Deutschland.

出版信息

Inn Med (Heidelb). 2025 Jul 1. doi: 10.1007/s00108-025-01948-8.

Abstract

The transfusion of donor lymphocytes after allogeneic stem cell transplantation (known as donor lymphocyte infusion, DLI) is the oldest form of cellular immunotherapy. The therapeutic effect is based on the polyclonal reaction of the transferred immune effector cells of the donor against the underlying malignant disease, the graft versus malignancy reaction (GvM). Based on findings from the canine model, DLI has been used for over 30 years, primarily for the prophylaxis and treatment of recurrence of hematological neoplasms after allogeneic transplantation, whereby the various diseases exhibit very different sensitivities to the GvM effect. As a result, both the indications and the potential combination of DLI with classical chemotherapy and newer drugs are different. The main complication of DLI is the induction of a graft versus host disease, the risk of which is influenced in particular by the human leukocyte antigen (HLA) match between donor and recipient as well as the dosage and timing of DLI. Based on large registry data, recommendations for the implementation of DLI in the various constellations and indications have been developed in recent years, which have already proven to be easy to implement in practice. This article summarizes the basic principles, clinical use and recommendations for application.

摘要

异基因干细胞移植后输注供体淋巴细胞(称为供体淋巴细胞输注,DLI)是细胞免疫治疗的最古老形式。其治疗效果基于供体转移的免疫效应细胞针对潜在恶性疾病的多克隆反应,即移植物抗恶性肿瘤反应(GvM)。基于犬模型的研究结果,DLI已应用30多年,主要用于异基因移植后血液系统肿瘤复发的预防和治疗,其中各种疾病对GvM效应的敏感性差异很大。因此,DLI的适应证以及与经典化疗和新药联合使用的可能性也有所不同。DLI的主要并发症是诱发移植物抗宿主病,其风险尤其受到供体与受体之间人类白细胞抗原(HLA)匹配情况以及DLI剂量和时机的影响。基于大型登记数据,近年来已制定了在各种情况和适应证下实施DLI的建议,这些建议在实践中已证明易于实施。本文总结了其基本原则、临床应用及应用建议。

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