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of a strong allogeneic GVL effect in ALL. In a Eastern Oncology Group Study / Medical Research Council in adults with ALL in first remission, the activity of t has been clearly established, GVL. Of 239 patients with Ph negative normal risk, which had a related donor, was the relapse rate by 24% versus 49% in 333 patients with KW 2449 standard risk who do not have a donor. Among Ph-negative patients at high risk of relapse rates by 37% for 204 patients with a donor against 63% for 261 patients without a donor. In particular, by erh Increase the intensity t of GVHD prophylaxis with an h Associated higher risk of relapse after alloHSCT adults and children with ALL.
Given the strong GVL effect in all DLI is an attractive therapeutic option for treatment of non return Cases after allogeneic transplantation. CI-1033 In practice, unlike the LMC, they are almost never effective in all the state flower of recurrence. There are several factors that determine the effectiveness against all DLI may be limited. Clinically, the rapid spread of all is often the case that the kinetics of progression of the disease, the time for maximum effect GVL exceed taken. Furthermore, in contrast to myeloma cells Of B-lymphoblast lines have very low expression of T-cell Porter et al. Page 13 of Biol Blood Marrow Transplant. Author manuscript, increases available in PMC 2011 1 November. stimulatory molecules and co-antigens and B se and can induce T cell anergy Complete remissions were sometimes induced by DLI and / or withdrawal of immunosuppression in patients with ALL, although the response rate in big s series, about the very poor are , in the range of 0 to 20%.
Although remittances can be made k, Many induced by the additional keeping and use of chemotherapy are generally of short duration with few long-term survivors. As observed in CML, the response rate to DLI all h Forth in the DSM. DLI may remissions in about one-third of children with ALL is manifested before inducing relapse. Due to the low probability of achieving a lasting L CR solution, LTD, are not considered standard for patients with relapsed after alloHSCT. Second allogeneic As described above, a second allogeneic transplant one of the treatment options that offer the opportunity for long-term survival after recurrence is of acute lymphoblastic leukemia Chemistry after a alloHSCT.
However, rates of CRT-related allogeneic second are extremely high. Connected to the use of non-myeloablative and reduced intensity t conditioning regimens may reduce transplant with CRT second and erm Resembled the realization of GVL elimination of residual-induced ALL. Unfortunately, there is very little data reporting alloHSCT RIC in ALL. The EBMT VER Software released the results of 97 patients with ALL, who U alloHSCT RIC again. However, there was a very big heterogeneity e t among patients with different patterns of reduced intensity t air conditioning. Obviously, some plans were reduced conditioning Similar to what others see as a standard myeloablative conditioning. A retrospective analysis of 27 patients To show U alloHSCT RIC again, with data from four prospective, multicenter, tried whether a difference in recurrence rates between patients have, or which has not GVHD. Although relapse was lower in patients with GVHD, the analysis was retrospective and the numbers were small one Hnlicher report from Japan reported alloHS RIC
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