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Graft-versus-leukemia effect in acute lymphoblastic leukemia: the importance of tumor burden and early detection

Leukemia volume 18, pages 1156–1158 (2004)Cite this article

TO THE EDITOR

Relapse in acute lymphoblastic leukemia (ALL) following hematopoietic stem cell transplant carries an extremely poor prognosis. Relapses of chronic myelogenous leukemia, acute myelogenous leukemia and myelodysplastic syndrome post-transplant have been shown to be responsive to immunologic manipulations such as reductions in immunosuppression and donor lymphocyte infusions. Attempts at similar treatment approaches in ALL have been far less successful and bring into question the efficacy of a graft-versus-leukemia (GVL) effect in this disease.1 There is, however, considerable evidence that a graft versus leukemia (GVL) effect might exist in ALL. Relapse rates are lower in allogeneic transplants compared with autologous transplants. Similar findings in syngeneic transplants suggest that lack of GVL, rather than tumor contamination, results in an increased rate of relapse in the autologous setting.2 Interferon use immediately post-allogeneic transplant may reduce the relapse rate through stimulation of an immunologic response.3 Finally, multiple studies show statistically significant reductions in relapse rates in patients who develop acute GVHD, chronic GVHD or both.4

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Authors and Affiliations

  1. Division of Pediatric Oncology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    S M Bradfield

  2. Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    J P Radich

  3. HematoLogics, Incorporation, Seattle, WA, USA

    M R Loken

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  1. S M Bradfield
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  2. J P Radich
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  3. M R Loken
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Correspondence to S M Bradfield.

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This work was supported in party by a National Cancer Institute grant, CA-18029.

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Bradfield, S., Radich, J. & Loken, M. Graft-versus-leukemia effect in acute lymphoblastic leukemia: the importance of tumor burden and early detection. Leukemia 18, 1156–1158 (2004). https://doi.org/10.1038/sj.leu.2403352

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