Soiffer R J, Alyea E P, Ritz J
Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02115, USA.
J Clin Apher. 1995;10(3):139-43. doi: 10.1002/jca.2920100308.
Recently, donor lymphocyte infusions have been successfully used to treat patients with CML who have relapsed following allogeneic bone marrow transplantation (BMT). Responses can be achieved in more than 60-70% of patients with stable phase CML without the need for the additional high dose cytotoxic chemotherapy that would accompany a second transplant procedure. The clinical and molecular remissions induced by this approach are a clear demonstration of graft-versus-leukemia (GVL) activity. Although undoubtedly donor lymphocyte infusions are safer than a second BMT, they are associated with toxicities stemming from graft-versus-host disease (GVHD) and pancytopenia. In this review, the immunomodulatory mechanisms underlying the GVL activity of donor allogeneic lymphocytes infusions are presented. Unresolved issues regarding lymphocyte administration are discussed as well as potential ways to limit complications due to GVHD and pancytopenia. New potential applications of this immunotherapeutic approach for treatment of infectious disease and non-hematologic malignancies will be presented.
最近，供体淋巴细胞输注已成功用于治疗异基因骨髓移植（BMT）后复发的慢性粒细胞白血病（CML）患者。超过60%-70%处于慢性期的CML患者通过该方法可获得缓解，且无需进行第二次移植手术时所需的额外高剂量细胞毒性化疗。这种方法诱导的临床和分子缓解清楚地证明了移植物抗白血病（GVL）活性。尽管供体淋巴细胞输注无疑比第二次BMT更安全，但它们与移植物抗宿主病（GVHD）和全血细胞减少引起的毒性相关。在这篇综述中，介绍了供体异基因淋巴细胞输注GVL活性的免疫调节机制。讨论了淋巴细胞给药方面尚未解决的问题以及限制GVHD和全血细胞减少并发症的潜在方法。还将介绍这种免疫治疗方法在治疗传染病和非血液系统恶性肿瘤方面的新潜在应用。
