Induction of HA‐1‐specific cytotoxic T‐cell clones parallels the therapeutic effect of donor lymphocyte infusion

Abstract
Summary. Donor lymphocyte infusions (DLI) can induce a graft‐versus‐leukaemia (GvL) reaction in patients with relapsed disease. However, the mechanisms involved in remission induction are not completely known. A patient with chemotherapy‐refractory relapse 1 year after human leucocyte antigen (HLA)‐identical, unrelated stem cell transplantation (SCT) for bcr/abl‐positive common acute lymphoblastic leukaemia (ALL) received a DLI from the original donor, and achieved complete cytogenetic and molecular remission concomitantly with extensive graft‐versus‐host disease (GvHD). Seven CD8+, donor‐derived, alloreactive T‐cell clones were generated by stimulating post‐DLI remission cells with the patient's pretransplant mature dendritic cells. The minor histocompatibility antigen (mHag) recognized by these T‐cell clones was identified as HA‐1, a mHag associated with acute GvHD after SCT. Our finding provides evidence of HA‐1‐associated GvL effects after DLI that paralleled the eradication of full‐blown, chemotherapy‐refractory ALL relapse after allogeneic SCT.

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