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Bonini, C. et al. HSV-TK gene transfer into donor lymphocytes for control of allogeneic graft-versus-leukemia.
When conditioning-induced inflammation has subsided, donor lymphocytes are then transplanted, which mediate a 'lymphohaematopoietic GVH response'.
Different strategies have been investigated to obtain all the benefits derived from donor lymphocytes while avoiding the risk of GvHD.
In allogeneic hematopoietic cell transplantation (allo-HCT), donor lymphocytes play a central therapeutic role in both GvL and immune reconstitution.
We aimed to systematically add back genetically engineered donor lymphocytes to facilitate immune reconstitution and prevent late mortality.
Red cells represent autoreactive host lymphocytes; green cells represent non-autoreactive host lymphocytes; yellow denotes donor lymphocytes; blue cells represent HSC.
The infusion of unmanipulated donor lymphocytes (DLIs) that contain virus-specific T cells is not feasible because of the risk of GvHD.
Patients also receive medications to suppress donor lymphocytes from attacking the transplant recipient's body, which can cause life-threatening graft-vs-host disease.
The mixed cell grafts will be processed so that only pure stem cells will be infused, devoid of contaminating donor lymphocytes that cause graft-vs-host disease.
This situation is different for allogeneic transplantation for which the infusion of donor lymphocytes has shown disease regression, especially in patients with chronic leukemias.
As a final precaution before grafting, a direct crossmatch is performed between the recipient's serum and donor lymphocytes.
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