Donor lymphocyte infusion

Donor lymphocyte (or leukocyte) infusion (DLI) or buffy coat infusion is a form of adoptive immunotherapy used after hematopoietic stem cell transplantation.

History

Formerly, the only treatment option that offered relapsed bone marrow transplant patients hope of a cure was another bone marrow transplant. However, the risk of serious, life-threatening complications after a second BMT is great. One strategy of managing relapse, donor leukocyte infusion, might eliminate the need for a second BMT in some patients.[citation needed]

Procedure

Donor lymphocyte infusion is the infusion in which lymphocytes from the original stem cell donor are infused, after the transplant, to augment an anti-tumor immune response or ensure that the donor stem cells remain engrafted.[1][2] These donated white blood cells contain cells of the immune system that can recognize and destroy cancer cells.[citation needed]

The goal of this therapy is to induce a remission of the patient's cancer by a process called the graft-versus-tumor effect (GVT). The donor T-cells can attack and control the growth of residual cancer cells providing the GVT effect. It is hoped that the donor leukocyte infusion will cause GVT and lead to a remission of the patients cancer. Patients might require standard chemotherapy, to reduce the amount of cancer cells they have prior to their donor lymphocyte infusion.[citation needed]

Complications

Complications of DLI include acute and chronic graft-versus-host disease and bone marrow aplasia, resulting in immunosuppression and susceptibility to opportunistic infections.[3]

References

  1. ^ Porter D, Levine JE (2006). "Graft-versus-host disease and graft-versus-leukemia after donor leukocyte infusion". Semin. Hematol. 43 (1): 53–61. doi:10.1053/j.seminhematol.2005.09.005. PMID 16412789.
  2. ^ Loren AW, Porter DL (2006). "Donor leukocyte infusions after unrelated donor hematopoietic stem cell transplantation". Current Opinion in Oncology. 18 (2): 107–14. doi:10.1097/01.cco.0000208781.61452.d3. PMID 16462177. S2CID 36578751.
  3. ^ Luznik L, Fuchs EJ (2002). "Donor lymphocyte infusions to treat hematologic malignancies in relapse after allogeneic blood or marrow transplantation". Cancer Control. 9 (2): 123–37. doi:10.1177/107327480200900205. PMID 11965233. S2CID 24188166.

Further reading

  • Thomas' Hematopoietic Cell Transplantation, ed. Blume KG, Forman SJ, Appelbaum FR. Blackwell Publishers, Cambridge, MA: 2004. ISBN 1-4051-1256-5.