T cell-mediated graft-versus-leukemia reactions after allogeneic stem cell transplantation |
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Authors: | Johannes Schetelig Alexander Kiani Marc Schmitz Gerhard Ehninger Martin Bornhäuser |
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Affiliation: | (1) Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307 Dresden, Germany;(2) Institut für Immunologie, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany |
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Abstract: | Allogeneic hematopoietic stem cell transplantation represents the only curative approach for many hematological malignancies. During the last years the impact of the conditioning regimen has been re-assessed. With the advent of reduced-intensity conditioning the paradigm has changed from cytoreduction executed by high-dose radio-chemotherapy to immunological surveillance of leukemia by donor cells. Distinct subsets of T cells and NK cells contribute to graft-versus-leukemia reactions. So far, cytotoxic T lymphocytes are the mainstay of allogeneic immunotherapy. Here, we summarise the current knowledge of T cell-mediated graft-versus-leukemia reactions and present results from pre-clinical and clinical studies of T cell-based adoptive immunotherapy. We address the issues of feasibility and specificity of adoptive immunotransfer from a clinical point of view and discuss the prerequisites for successful clinical applications. Finally, the prospects for immunological research that have evolved with the increasing use of reduced-intensity conditioning and allogeneic stem cell transplantation are highlighted. |
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Keywords: | Allogeneic hematopoietic stem cell transplantation Reduced-intensity conditioning Graft-versus-leukemia effects Minor histocompatibility antigens Tumor antigens |
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