Who may benefit from donor leucocyte infusions after allogeneic stem cell transplantation?

Abstract

Donor leucocytes are able to induce remissions in patients who relapse after allogeneic SCT. The effectors of this GVL effect are assumed to be donor T cells. The best treatment schedule for using donor leucocytes remains to be determined. It is possible that a certain threshold number of donor T cells is necessary to obtain a GVL effect and that this threshold might be determined by a number of factors, including time from SCT, donor-recipient alloreactivity and diagnosis. This optimum number may be different in patients receiving unseparated compared with CD8+-depleted T cells. Randomized trials will be required to resolve many of these issues.