Hematopoietic stem cell–mediated graft-versus-leukemia immune effect (GvL)

The hematopoietic stem cell–mediated graft-versus-leukemia (GvL) immune effect is a complex biological phenomenon rather than a single molecular target. It represents the primary therapeutic mechanism of allogeneic hematopoietic stem cell transplantation (allo-HSCT), where donor-derived immune cells, particularly T lymphocytes and natural killer (NK) cells, identify and eliminate residual malignant cells in the recipient (Appelbaum, 2001, Nature). This effect is primarily mediated through the recognition of minor histocompatibility antigens (mHags) or tumor-associated antigens (TAAs) presented on the surface of leukemic cells (Bleakley & Riddell, 2004, Nature Reviews Cancer). While GvL is essential for preventing disease relapse, it is frequently associated with graft-versus-host disease (GvHD), a condition where donor cells attack healthy host tissues (Horowitz et al., 1990, Blood). Pharmacological management often involves a delicate balance: immunosuppressants like tacrolimus are used to prevent GvHD but may diminish GvL, while donor lymphocyte infusions (DLI) or immune checkpoint inhibitors may be used to enhance GvL in patients with relapsed disease (Zeiser & Blazar, 2017, New England Journal of Medicine). Consequently, GvL is a clinical outcome and therapeutic goal of cellular therapy rather than a discrete receptor or enzyme.

Other names

Graft-versus-leukemia effectGvL effectGraft-versus-tumor effectGvTGraft-versus-malignancy effect

Modulation of donor-derived T-cell and natural killer (NK) cell activity to recognize and eliminate recipient malignant cells through the targeting of minor histocompatibility antigens or tumor-associated antigens.