Medicine: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
- ↑ "Graft-versus-host disease and graft-versus-leukemia after donor leukocyte infusion". Semin. Hematol. 43 (1): 53–61. 2006. doi:10.1053/j.seminhematol.2005.09.005. PMID 16412789.
- ↑ "Donor leukocyte infusions after unrelated donor hematopoietic stem cell transplantation". Current Opinion in Oncology 18 (2): 107–14. 2006. doi:10.1097/01.cco.0000208781.61452.d3. PMID 16462177.
- ↑ "Donor lymphocyte infusions to treat hematologic malignancies in relapse after allogeneic blood or marrow transplantation". Cancer Control 9 (2): 123–37. 2002. doi:10.1177/107327480200900205. PMID 11965233.
Further reading
- Thomas' Hematopoietic Cell Transplantation, ed. Blume KG, Forman SJ, Appelbaum FR. Blackwell Publishers, Cambridge, MA: 2004. ISBN:1-4051-1256-5.
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