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Temporal discordance between graft-versus-leukemia and graft-versus-host responses: a strategy for the separation of graft-versus-leukemia/graft-versus-host reactivity? Biol Blood Marrow Transplant 2004 Nov;10(11):743-7 PMID: 15505605

Pubmed ID

15505605

Abstract

The graft-versus-leukemia (GVL) effect is often coexpressed with graft-versus-host disease (GVHD), although the temporal kinetics of these responses have not been critically examined. To evaluate this question in the absence of the confounding effects of the conditioning regimen, 23 patients who received donor lymphocyte infusions from HLA-identical siblings and subsequently developed GVHD and/or a GVL response were studied to determine whether these were temporally synchronous events. The GVL effect occurred significantly earlier than GVHD, being that 19 of 23 patients had a sustained GVL response that antedated the onset of clinical GVHD. The median difference between time to GVL and graft-versus-host (GVH) reactivity in the entire cohort was 14 days. There was no correlation between total T-cell dose and the relative onset of GVL versus GVH reactivity, indicating that temporal dissociation of GVL and GVH responses was not a function of the absolute number of infused donor T cells. These data support existing murine bone marrow transplantation studies indicating that GVL and GVH responses are not temporally synchronous events and raise the possibility that targeted elimination of alloreactive donor T cells after bone marrow transplantation may be an effective strategy for the separation of GVL/GVH reactivity.

Author List

Hari P, Logan B, Drobyski WR

Authors

William R. Drobyski MD Professor in the Medicine department at Medical College of Wisconsin
Parameswaran Hari MD Chief, Professor in the Medicine department at Medical College of Wisconsin
Brent R. Logan PhD Director, Professor in the Institute for Health and Equity department at Medical College of Wisconsin




Scopus

2-s2.0-6444236370   7 Citations

MESH terms used to index this publication - Major topics in bold

Adult
Animals
Bone Marrow Transplantation
Female
Graft vs Host Disease
Graft vs Leukemia Effect
Humans
Leukemia
Lymphocyte Transfusion
Male
Mice
Middle Aged
Retrospective Studies
jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6