TREATMENT OF LEUKEMIC RELAPSE AFTER ALLOGENEIC BONE MARROW TRANSPLANTATION, DONOR LEUKOCYTE INFUSION AS A NEW THERAPEUTIC OPTION

Abstract

Bone marrow transplantation (B.M.T.) involves the intravenous infusion of hematopoietic stem cells to re­ establish. marrow function in a patient with a damaged or defective bone marrow. T his stem cell is defined by 2 characteristics: 1-Its ability to generate progeny. 2-Its capacity to preserve this function. Sources of hematopoietic stem cells are bone marrow, peripheral blood, umbilical cord blood, or fetal liver cells. The types of B.M.T. are syngeneic, allogeneic, or autologous. The applications ofB.M.T.inclu-de: congenital disorders, aplastic anemia leukemias, myelodysplastic syndromes & other hematologic malignancies. The most important complications ofB.M.T. include G.V.H.D., post -transplant infections & relapse of malignancy. G.V.H.D. is a syndrome of skin, liver &gut disease with immunodeficiency caused by allogeneic T-lymphocytes given during transplantation. The living immunocompetent cells as lymphocytes or stem cells from the donor cause an immunologic reaction against host tissues. G.VH.D. is either acute or chronic. Prevention and treatment ofG.V.H.D. have focused on 2 principal approaches: 1- The administration of combinations of immuno­ suppressive drugs immediately prior to and following unmodified B.M.T.