Donor lymphocyte (or leukocyte) infusion (DLI) or buffy coat infusion is a form of adoptive immunotherapy used after hematopoietic stem cell transplantation.
Formerly, the only treatment option that offered relapsed bone marrow transplant patients hope of a cure was another bone marrow transplant. However, the risk of serious, life-threatening complications after a second BMT is great. One strategy of managing relapse, donor leukocyte infusion, might eliminate the need for a second BMT in some patients.[ citation needed ]
Donor lymphocyte infusion was first used in 1990 in LMU Klinikum in Munich, Germany. The treatment was tested in three patients suffering from a relapse of chronic myelogenous leukemia after bone marrow transplantation. After DLI, all three recovered and showed complete remission. [1]
Donor lymphocyte infusion is the infusion in which lymphocytes from the original stem cell donor are infused, after the transplant, to augment an anti-tumor immune response or ensure that the donor stem cells remain engrafted. [2] [3] These donated white blood cells contain cells of the immune system that can recognize and destroy cancer cells.[ citation needed ]
The goal of this therapy is to induce a remission of the patient's cancer by a process called the graft-versus-tumor effect (GVT). The donor T-cells can attack and control the growth of residual cancer cells providing the GVT effect. It is hoped that the donor leukocyte infusion will cause GVT and lead to a remission of the patients cancer. Patients might require standard chemotherapy, to reduce the amount of cancer cells they have prior to their donor lymphocyte infusion.[ citation needed ]
Complications of DLI include acute and chronic graft-versus-host disease and bone marrow aplasia, resulting in immunosuppression and susceptibility to opportunistic infections. [4]