Donor lymphocyte infusion
{{Short description|Therapy used in the field of bone marrow transplantation}}
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|date=December 2019}}
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.{{cite journal |vauthors=Porter D, Levine JE |title=Graft-versus-host disease and graft-versus-leukemia after donor leukocyte infusion |journal=Semin. Hematol. |volume=43 |issue=1 |pages=53–61 |year=2006 |pmid=16412789 |doi=10.1053/j.seminhematol.2005.09.005}}{{cite journal |vauthors=Loren AW, Porter DL |title=Donor leukocyte infusions after unrelated donor hematopoietic stem cell transplantation |journal=Current Opinion in Oncology |volume=18 |issue=2 |pages=107–14 |year=2006 |pmid=16462177 |doi=10.1097/01.cco.0000208781.61452.d3|s2cid=36578751 }} These donated white blood cells contain cells of the immune system that can recognize and destroy cancer cells.{{cn|date=February 2022}}
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|date=December 2019}}
Complications
Complications of DLI include acute and chronic graft-versus-host disease and bone marrow aplasia, resulting in immunosuppression and susceptibility to opportunistic infections.{{cite journal |vauthors=Luznik L, Fuchs EJ |s2cid=24188166 |title=Donor lymphocyte infusions to treat hematologic malignancies in relapse after allogeneic blood or marrow transplantation |journal=Cancer Control |volume=9 |issue=2 |pages=123–37 |year=2002 |pmid=11965233 |doi=10.1177/107327480200900205}}
References
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Further reading
- Thomas' Hematopoietic Cell Transplantation, ed. Blume KG, Forman SJ, Appelbaum FR. Blackwell Publishers, Cambridge, MA: 2004. {{ISBN|1-4051-1256-5}}.
{{DEFAULTSORT:Donor Lymphocyte Infusion}}