Graft-versus-leukemia effect (GvL) (GvL)

The Graft-versus-leukemia (GvL) effect, often referred to as the hematopoietic stem cell / immune graft-versus-leukemia interface, is a biological phenomenon where donor-derived immune cells recognize and eliminate residual malignant cells in a recipient after allogeneic hematopoietic stem cell transplantation (Horowitz et al., 1990, Blood). This interface is primarily mediated by donor T lymphocytes and natural killer (NK) cells that identify minor histocompatibility antigens or tumor-associated antigens presented on the surface of leukemic cells (Bleakley & Riddell, 2004, Nature Reviews Cancer). While GvL is the primary curative mechanism of transplantation for hematologic malignancies like leukemia and lymphoma, it is frequently associated with graft-versus-host disease (GvHD), where donor cells attack healthy recipient tissues (Zeiser & Vago, 2019, Blood). Therapeutic strategies targeting this interface aim to enhance anti-tumor immunity using checkpoint inhibitors or hypomethylating agents while minimizing systemic toxicity through selective immunosuppression (StatPearls, 2023). The complexity of this interface involves a delicate balance of T-cell activation, cytokine signaling, and the suppressive influence of the tumor microenvironment.

Other names

Hematopoietic stem cell / immune graft-versus-leukemia interfaceGraft-versus-tumor effectGvTAllo-immune anti-leukemic response

The GvL effect is mediated by the immunological synapse between donor T-cell receptors (TCR) and recipient antigens (minor histocompatibility antigens or tumor-specific antigens) presented on MHC molecules, leading to targeted cytotoxicity via perforin, granzymes, and Fas-ligand pathways, as well as the production of anti-tumor cytokines like interferon-gamma (Bleakley & Riddell, 2004, Nature Reviews Cancer).