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T-Cells, Graft-Versus-Host Disease, and Graft-Versus-Leukemia

New Approaches for Blood and Marrow Transplantation

  • Chapter
Molecular Biology of Hematopoiesis 5

  • 92 Accesses

Abstract

Allogeneic bone marrow transplantation is most commonly used as treatment for leukemia. Allotransplantation is associated with several interrelated immunologic processes, graft rejection, graft-vs-host disease and graft-vs-leukemia. Graft rejection can be overcome by intensive pretransplant immunosuppressive therapy. Following transplantation immunoreconstitution must occur from donor derived progenitors and graft-vs-host disease may occur from reactivity of donor derived immunocompetant cells against host tissues. In a related, but distinct process, donor immunocompetant cells may react against the recipient leukemia and recent data confirm that this GVL effect plays a critical role to prevent relapse post transplant. This report summarizes present data regarding the mechanism of these processes. A major challange is to separate the beneficial GVL effect from GVHD, the major complication of allogeneic marrow transplantation. In this report we summarize data regarding innovative approaches to modify the composition of the transplanted marrow to optimize clinical outcome as well as use of donor lymphocyte infusions as a means to induce graft-vs-leukemia post transplant. In this report we summarize data regarding innovative approaches to modify the composition of the transplanted marrow to optimize clinical outcome as well as use of donor lymphocyte infusions as a means to induce graft-vs-leukemia post transplant.

The biologic effects of allogeneic bone marrow transplantation depend upon the composition of the graft. The goal is to achieve engraftment and hematopoietic recovery and avoid the development of graft-versus-host disease (GVHD). For patients transplanted for leukemia, another important component is the immune mediated graft-versus-leukemia effect, important to prevent relapse.

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Authors and Affiliations

  1. Section of Bone Marrow Transplantation Department of Hematology Division of Medicine, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 65, Houston, Texas, 77030, USA

    Richard Champlin, Sergio Giralt & James Gajewski

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  1. Richard Champlin
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  2. Sergio Giralt
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  3. James Gajewski
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Editors and Affiliations

  1. The Rockefeller University, New York, New York, USA

    Nader G. Abraham

  2. University of Tokyo, Tokyo, Japan

    Shigetaka Asano

  3. Universität-Gesamthoschschule Essen, Essen, Germany

    Günther Brittinger

  4. Istituto Cantonale di Patologia, Locarno, Switzerland

    Georges J. M. Maestroni

  5. Western Pennsylvania Cancer Institute, Pittsburgh, Pennsylvania, USA

    Richard K. Shadduck

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© 1996 Plenum Press, New york

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Champlin, R., Giralt, S., Gajewski, J. (1996). T-Cells, Graft-Versus-Host Disease, and Graft-Versus-Leukemia. In: Abraham, N.G., Asano, S., Brittinger, G., Maestroni, G.J.M., Shadduck, R.K. (eds) Molecular Biology of Hematopoiesis 5. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0391-6_1

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