Graft Versus Leukemia

Abstract

Publisher Summary This chapter discusses the work in progress to develop a treatment plan for patients with refractory and/or recurrent acute leukemia. The experiments described are being made on leukemic mice and have been planned in such a way as to simulate some of the unsolved problems of acute leukemia in man. Chemotherapy, radiotherapy, and adoptive immunotherapy have been combined in a treatment model that has the potential for clinical applicability. The key feature of the treatment model is a transplant of immunologically competent cells obtained from a healthy donor. The transplanted immunocompetent cells are asked to eradicate residual leukemia cells in the host after intensive, but noncurative, conventional antileukemic therapy. A chemoradioadoptive immunotherapeutic model for the treatment of murine leukemia with potential for clinical applicability has been described. A temporary graft versus leukemia (GVL) reaction is the key feature of the model. The term GVL reaction is used to signify the adoptive immunotherapeutic effect of transplanted immunologically competent cells from an allogeneic donor on leukemia cells in an immunosuppressed host. The graft versus host disease was circumvented. Cell cure of 88% of AKR mice bearing a virulent lymphocytic leukemia was achieved. Late mortality occurred in 58% of the mice because of bone marrow and lymphoid aplasia. Perfection of this treatment model will lead to a treatment plan that can be used for patients with refractory and/or recurrent acute leukemia.