Immunotherapy by allogeneic lymphocytes and cytokines following autologous and allogeneic bone marrow stem cell transplantation

This chapter presents several alternative therapeutic approaches based on passive adoptive transfer of immunocompetent donor allogeneic bone marrow or peripheral blood lymphocytes (PBL) or in vitro activated allogeneic PBL, with or without further in vivo activation of effector cells with recombinant human interleukin 2. The role of allogeneic cell-therapy in conjunction with BMT is best documented by comparing the rate of relapse of patients undergoing syngeneic and autologous BMT in comparison with allogeneic BMT, both being conditioned by identical myeloablative protocols. After induction of stable chimerism recipients are expected to accept donor lymphocytes and permit induction of effective graft vs-leukemia. The use of adoptive allogeneic cell therapy for the treatment of cancer represents the beginning of a new era in applying biological therapy of cancer. In the future, tumor-selective effector cells may be obtained by choosing well-defined T cell subsets, with possible further in vitro expansion and activation of anti-cancer effector cells.