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Exercise-mobilized donor lymphocyte infusion (E-DLI) is an experimental adoptive cellular therapy designed to enhance the graft-versus-leukemia (GVL) effect in patients who have relapsed after allogeneic hematopoietic stem cell transplantation (HSCT). The protocol involves having the original stem cell donor perform a single session of vigorous aerobic exercise immediately before blood collection. This physical exertion triggers a rapid, adrenergic-mediated mobilization of highly cytotoxic immune cell subsets—particularly natural killer (NK) cells and CD8+ T cells—from marginal pools into the peripheral circulation. These mobilized lymphocytes are collected via apheresis or venipuncture and infused into the recipient. The primary objective is to provide a more potent immune graft compared to standard 'resting' DLI, potentially increasing tumor surveillance and clearance while maintaining or improving the safety profile regarding graft-versus-host disease (GVHD).
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