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由供者T细胞介导的同种异体反应性,可在异基因移植后产生持久的免疫控制,或消除微小残留病。作为过继免疫治疗的重要方法,近年来随着研究的深入,我们对供者淋巴细胞输注(donor lymphocyte infusion,DLI)效应机制有了新的认识。现在,DLI的研究主要集中在:增强移植物抗白血病(GVL)效应以及促进特异性免疫调节反应,抑制GVHD而不削弱GVL效应。例如:输注调节T细胞、预防性地进行CD8+细胞的去除、采用肿瘤特异的或mHA特异的CTL进行过继免疫治疗。DLI的修饰,如过继转移抗原特异性T细胞,转导自杀基因入供者淋巴细胞等,以及应用高敏感、定量RT-PCR技术加强DLI后分子水平监测,使得DLI临床疗效显著提高。
Alloreactive T-cell-mediated allograft reactivity can result in long-lasting immune control following allogeneic transplantation or the elimination of minimal residual disease. As an important method of adoptive immunotherapy, with the further research in recent years, we have a new understanding of donor lymphocyte infusion (DLI) mechanism. Now, the research of DLI mainly focuses on enhancing graft anti-leukemia (GVL) effect and promoting specific immunomodulatory response, inhibiting GVHD without impairing GVL effect. For example: infusion of regulatory T cells, prophylactic removal of CD8 + cells, and adoptive immunotherapy with tumor-specific or mHA-specific CTLs. DLI modification, such as adoptive transfer of antigen-specific T cells, transduction of suicide genes into donor lymphocytes, and the use of high-sensitivity, quantitative RT-PCR technology to enhance molecular monitoring after DLI, DLI clinical efficacy significantly improved.