In syngeneic bone marrow transplantation (BMT) and in recipients of autologous BMT, relapse rates are high. No MHC or minor histocompatibility antigen (mHag) disparities exist and thus no alloreactivities can be induced. This is clearly different in allogeneic BMT, where the relapse rates are significantly lower and a relationship is seen between the graft-versus leukemia (GVL) effect and acute and chronic graft-versus-host disease (GVHD). Likewise, donor lymphocyte infusion (DLI) therapy, inducing remission in relapsed chronic myeloid leukemia (CML) after allogeneic BMT, is frequently accompanied by GVHD. Thus, one may conclude that alloreactive donor T cells are involved in antileukemia reactivities. Human mHag are polymorphic antigens that are independent from HLA, expressed on leukemic cells, and recognized by alloreactive immune bone marrow donor T cells. It is therefore likely that in the HLA-identical situation, mHag participate in GVL reactivities. This review does not cover the information regarding the GVL effect of murine mHag. These and other experimental animal studies are described in Chapter 3. Here we summarize current knowledge of the putative impact of human mHag on the GVL effect in BMT and discusses the possible clinical application of mHag for immunotherapy of leukemia.
|Title of host publication||Allogeneic Immunotherapy for Malignant Diseases|
|Number of pages||15|
|Publication status||Published - 1 Jan 2000|