Donor Lymphocyte Infusion for T cell leukemia and lymphoma

Donor Lymphocyte Infusions)DLI) are designed to awaken some degree of graft versus host reaction, which contains within it also the graft versus disease effect. IN other words, by transfusing donor cells, an anti leukemia cell effect may be produced. It is a modality that can be used after allogeneic transplantation to treat relapse by “awakening” an immune response.. Almost all work on DLI was in B cell leukemias and lymphomas.  How it affects T cell malignancies is not well studied and most of what is known was in Adult T-Cell leukami/Lymphoma. Many questions about DLI remain. For example,  achieving hematologic remission with DLI is not an easy task, especially in patients with a high tumor burden and rapidly proliferating leukemic cells. Cytoreductive therapy by giving chemotherapy before DLI is thought to improve effectiveness of DLI. Unfortunately, which regimens to use for this cytoreduction has not been defined. How to induce and manage graft versus so it does not damage the host more than the leukemia reaction has not been defined. Even the very effectiveness of allogeneic transplantation in T-Cell Leukemias continues to be studied. To conclude,  DLI remains experimental for T Cell malignancies due to lack of reliable information on how to do it and how effective it is.

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