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T cell-mediated graft-versus-leukemia reactions after allogeneic stem cell transplantation

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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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Acknowledgements

We would like to thank K. A. Kreuzer and U. Oelschlägel who provided data on the clearance of BCR-ABL transcripts and leukemic lymphocytes in CLL after allogeneic HSCT, respectively. We also are grateful to S. Reimer for skilful technical assistance.

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  1. Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Fetscherstr. 74, 01307, Dresden, Germany

    Johannes Schetelig, Alexander Kiani, Gerhard Ehninger & Martin Bornhäuser

  2. Institut für Immunologie, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany

    Marc Schmitz

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  1. Johannes Schetelig
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Correspondence to Johannes Schetelig.

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Schetelig, J., Kiani, A., Schmitz, M. et al. T cell-mediated graft-versus-leukemia reactions after allogeneic stem cell transplantation. Cancer Immunol Immunother 54, 1043–1058 (2005). https://doi.org/10.1007/s00262-005-0681-6

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