¹Bone Marrow and Stem Cell Transplant Program, University of Pennsylvania Abramson Cancer Center, Philadelphia, PA, USA

Correspondence: Dr AW Loren, Bone Marrow and Stem Cell Transplant Program, University of Pennsylvania Abramson Cancer Center, 16 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104, USA. E-mail: alison.loren@uphs.upenn.edu

Received 19 July 2007; Revised 6 September 2007; Accepted 7 September 2007; Published online 19 November 2007.

Abstract

Allogeneic stem cell transplantation (SCT) offers the only hope for cure for many adults with acute leukemia. Unfortunately, many patients relapse and die of their disease even after transplantation. Although in some cases, allogeneic SCT is effective because the intensive conditioning therapy eradicates all malignant cells, it has long been recognized that the adoptive transfer of donor immunity plays a critically important role in the induction and maintenance of remission. Recognition of the graft-versus-leukemia (GVL) effect of allogeneic SCT has prompted attempts at remission re-induction by adoptive immunotherapy with donor lymphocyte infusions (DLIs) in patients with relapsed disease after allogeneic SCT. In some cases, DLI-induced remissions are sustained and patients cured when no other treatment modality was effective. This review discusses the rationale, biology, complications and future applications of DLI in acute leukemia patients after allogeneic SCT.