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Donor lymphocyte infusion (DLI) is an adoptive cell therapy used in the context of allogeneic hematopoietic stem cell transplantation (HSCT). In the specific "Two-Step" reduced-intensity conditioning (RIC) protocol developed at the Sidney Kimmel Cancer Center at Thomas Jefferson University, DLI is administered following a conditioning regimen of fludarabine, thiotepa, and total body irradiation (TBI). This is followed by the administration of melphalan to induce T-cell tolerization, which aims to prevent graft-versus-host disease (GVHD) while preserving the graft-versus-leukemia (GVL) effect. This approach is being evaluated for high-risk hematologic malignancies, including acute leukemia, myelodysplastic syndromes, Hodgkin's lymphoma, non-Hodgkin's lymphoma, multiple myeloma, and chronic myeloid leukemia.
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