Confirmation that mismatched donor lymphocytes are even more effective than fully matched donor lymphocytes for treatment of multi-drug resistant cancer
This patient from Ankara, Turkey, was referred to Prof. Slavin for treatment for a very aggressive blood cancer that was fully- resistant to myeloablative conditioning supported by autologous stem cell transplantation. A second myeloablative transplant procedure was accomplished, this time using her fully-HLA-compatible sibling as a donor.
Unfortunately, leukemia recurred again. A third transplant procedure was proposed as a last resort, this time using her haploidentically mismatched mother stem cells. Following successful engraftment of mother’s hematopoietic cells, additional treatment was followed by administration of the mother’s blood lymphocytes activated with interleukin 2 (IL-2) to maximize the capacity of mismatched donor lymphocytes to kill all resistant malignant cells. Graft-versus-leukemia (GVL) effects were induced by eliminating T cells and focusing on the donor’s natural killer (NK) cells.
This prevented the hazardous graft-vs-host disease (GVHD). All malignant cells were eliminated with no clinical signs of GVHD and now, 18 years out, the patient enjoys an excellent quality of life, as shown in the pictures attached, heading a bank office in Ankara.
This case convinced Slavin that the most effective cell-mediated anti-cancer immunotherapy can be accomplished by intentionally mismatched killer cells that can be further activated by interleukin 2 (IL-2).