Klingemann H G, Phillips G L
Leukemia/Bone Marrow Transplant Program of British Columbia, Vancouver Hospital and Health Sciences Center, Canada.
Leuk Lymphoma. 1995 Feb;16(5-6):397-405. doi: 10.3109/10428199509054425.
Chemotherapy-resistant cells cause disease recurrence in a significant proportion of patients with acute leukemia treated with autologous stem cell transplantation due to the lack of immune-mediated effects which contribute significantly to the prevention of post-treatment disease recurrence. This conclusion is based on the observation that relapse after high dose chemotherapy supported by a stem cell transplant from a twin donor is 3-4 times higher than after transplant from an allogeneic donor. This anti-leukemic mechanism of transplanted donor cells has been termed graft-versus-leukemia (GVL) effect, and efforts are being directed toward utilizing such an immune-mechanism after autologous transplantation. Since interleukin-2 (IL-2) can induce remissions in selected patients with advanced leukemia, it has become a candidate cytokine to be used in attempts to introduce GVL after autologous stem cell transplantation. Here we review the available clinical data with IL-2 and critically evaluate whether IL-2 has a place as adjunct treatment to prevent relapse after autologous transplantation for acute leukemia.
化疗耐药细胞导致相当一部分接受自体干细胞移植治疗的急性白血病患者疾病复发，原因是缺乏对预防治疗后疾病复发有显著作用的免疫介导效应。这一结论基于以下观察结果：在双胞胎供体的干细胞移植支持下进行大剂量化疗后的复发率比同种异体供体移植后的复发率高3至4倍。移植的供体细胞的这种抗白血病机制被称为移植物抗白血病（GVL）效应，目前正在努力在自体移植后利用这种免疫机制。由于白细胞介素-2（IL-2）可使部分晚期白血病患者获得缓解，它已成为在自体干细胞移植后试图引入GVL效应时使用的候选细胞因子。在此，我们回顾了有关IL-2的现有临床数据，并严格评估IL-2作为辅助治疗预防急性白血病自体移植后复发是否有一席之地。
