[Donor lymphocyte infusion after allogeneic stem cell transplantation]

Area of Science:

• Immunotherapy
• Hematologic Malignancies
• Stem Cell Transplantation

Context:

• Donor lymphocyte infusion (DLI) is the oldest cellular immunotherapy, utilized for over 30 years post-allogeneic stem cell transplantation.
• Its efficacy relies on the graft-versus-malignancy (GvM) reaction, where donor immune cells target residual cancer.
• Disease sensitivity to GvM varies, influencing DLI indications and combination therapies.

Purpose:

• To summarize the fundamental principles, clinical applications, and practical recommendations for DLI.
• To outline strategies for optimizing DLI efficacy while mitigating risks.
• To provide evidence-based guidelines for DLI implementation in clinical practice.

Summary:

• DLI leverages donor T-cells to combat hematological neoplasms after allogeneic stem cell transplantation.
• Key considerations include varying disease sensitivity to GvM, HLA matching, and DLI dosage/timing.
• Graft-versus-host disease (GvMHD) is a significant complication, influenced by HLA compatibility and DLI parameters.

Impact:

• Facilitates informed clinical decision-making regarding DLI use in hematological malignancies.
• Contributes to the development of standardized protocols for DLI administration.
• Aims to improve patient outcomes by optimizing the risk-benefit ratio of DLI therapy.