Demonstration of the Gvl Effect after Hpc Transplantation

GVHD and relapse are two major causes of death after HPC transplantation.1 The most efficient method for prevention of GVHD consists of Tcell depletion of the graft.2-5 However, this usually leads to greatly increased risks of leukemia relapse,3,6,7 due to the loss of the graft-versus-leukemia (GVL) effect that has been recognized as an important component of the anti-leukemic efficacy of allogeneic HPC transplantation, particularly for chronic myelogenous leukemia (CML). The demonstration of this GVL effect and of the primordial role of T-lymphocytes led investigators to transfuse donor lymphocytes to CML patients relapsing after HPC transplantation.8-14 Indeed, donor lymphocyte infusions (DLIs) have increasingly been used to treat relapse after HPC transplantation not only for CML but also for acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), myelodysplastic syndrome (MDS), multiple myeloma (MM), and non-Hodgkin’s lymphoma.15-22 DEMONSTRATION OF THE GVL EFFECT AFTER HPC TRANSPLANTATION