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This therapeutic regimen, developed by the Abramson Cancer Center at Penn Medicine, combines non-myeloablative allogeneic peripheral blood progenitor cell transplantation with a subsequent prophylactic infusion of activated donor lymphocytes (ADLI). The protocol is specifically designed for patients with high-risk acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), or myelodysplastic syndromes (MDS). The core innovation involves the ex vivo activation of donor T-cells (typically using anti-CD3/anti-CD28 costimulation) prior to infusion. This activation is intended to enhance the graft-versus-leukemia (GVL) effect, improving the donor immune system's ability to identify and eliminate residual malignant cells and combat post-transplant infections, while potentially minimizing the severity of graft-versus-host disease (GVHD) compared to standard donor lymphocyte infusions.
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