ABSTRACT
Allogeneic bone marrow transplantation (BMT) is often used in the treatment of leukemias and lymphomas that are resistant to conventional chemoradiotherapy. Efficacy of BMT in eradicating leukemia results primarily from the high-dose chemotherapy and radiation given pretransplant. The possibility that allogeneic BMT might destroy leukemia "by the reaction of immunity" was recognized in the earliest days of experimental BMT, and graft-vs-leukemia (GVL) and Graft-versus-host (GVH) reactions have been studied extensively in various animal models. Regardless of the strategy to address Graft versus host disease, preservation of the antileukemic or GVL effect is critically important when leukemic cells are not eliminated by pretransplant therapy. While the primary targets for GVH reactions are class one and class two molecules encoded within the major histocompatibility complex (MHC), the presumptive target molecules, with BM donors and recipients that are phenotypically or genotypically MHC-identical, are minor histocompatibility recognized in association with MHC molecules.
