Allogeneic Immunotherapy for Malignant Diseases PDF

Preface

Allogeneic stem-cell transplantation is becoming an essential component of clinical hematology and oncology practice. The curative effect of allogeneic stem cell transplantation is attributed at least partially to an allogeneic immune response: the graft-versus-leukemia (GVL) or graft-versus-tumor (GVT) effect. For the last decade or so, our perception of the GVL phenomenon has changed dramatically. We observed in the mid-'80s that depletion of T cells from the graft dramatically increased the rate of leukemia relapse; subsequently it became evident that remissions could be reinduced by donor lymphocyte transfusions to patients with leukemia relapsing after bone marrow transplantation. Although variable in its expression, the allogeneic GVT effect appears to extend to a variety of acute and chronic myeloid and lymphoid malignancies and possibly solid tumors. With new insights into the cellular and molecular biology of GVL, we have advanced from the stage of trying to prove the existence of a GVL effect to understanding it better and applying it more effectively.

Anyone reading current publications on bone marrow transplantation will have noticed a growing number of original papers and review articles on GVL which signal an increased awareness and demand for information on the topic. Alongside the applied research in GVL, there are continuing advances in cellular immunology and tumor immunology that improve our understanding of the alloresponse to malignancies. Looking forward to the next decade, the use of allogeneic cells promises important therapeutic benefits for our patients. In this book, authors who are leaders in their respective fields provide a comprehensive review of the GVL/GVT effect, from descriptions of the alloimmune responses to the clinical applications of GVL. We hope this book will bring to its readership state of- the-art knowledge on the subject and also indicate directions for future research and therapeutic applications in GVL.