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CD8-depleted donor lymphocyte infusion (DLI) is an investigational adoptive cell therapy primarily used to treat hematologic malignancies, such as myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). The therapy involves the infusion of donor lymphocytes that have been selectively depleted of CD8+ T cells, typically using the CliniMACS system, to enrich for CD4+ T cells. By utilizing HLA-mismatched unrelated donors, the infused CD4+ T cells are activated by the recipient's mismatched HLA Class II antigens. This activation is intended to provide immunologic help that reverses recipient T-cell exhaustion and induces a potent graft-versus-leukemia (GVL) effect. A key feature of this approach is that the CD8 depletion and HLA mismatch prevent long-term donor cell engraftment, thereby mitigating the risk of graft-versus-host disease (GVHD) while serving as a bridge to definitive allogeneic hematopoietic cell transplantation (HCT).
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