Barrett A J
Hematology Branch, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland 20892, USA.
Stem Cells. 1997;15(4):248-58. doi: 10.1002/stem.150248.
It is now clear that the graft-versus-leukemia (GVL) effect which accompanies allogeneic bone marrow transplantation for hematological malignancies is a powerful therapeutic weapon which, if harnessed, could improve our ability to treat refractory malignant disorders. Advances in the understanding of the alloimmune response now provide a clearer picture of the mechanisms involved in the GVL reaction: the CD4+ T cell plays a central role in the orchestration of leukemia cell killing. The immunogenicity of the leukemia is also a major factor determining the effectiveness of the GVL response. The characterization of antigens restricted to leukemia and hematopoietic tissues should make it eventually possible to produce specific and powerful antileukemic alloresponses in donor lymphocytes by adoptive immunotherapy or by vaccines.
现在很清楚，异基因骨髓移植治疗血液系统恶性肿瘤时伴随的移植物抗白血病（GVL）效应是一种强大的治疗武器，如果加以利用，可提高我们治疗难治性恶性疾病的能力。目前对同种异体免疫反应的认识进展，使我们对GVL反应所涉及的机制有了更清晰的了解：CD4 + T细胞在协调白血病细胞杀伤中起核心作用。白血病的免疫原性也是决定GVL反应有效性的一个主要因素。对局限于白血病和造血组织的抗原进行表征，最终应能通过过继性免疫疗法或疫苗在供体淋巴细胞中产生特异性且强大的抗白血病同种异体反应。
