The role of the immune response in the control and eradication of leukaemia after allogeneic bone marrow transplantation is established but there is increasing evidence that the principal mechanism of cure after intensive chemo- therapy alone is also immune mediated. The idea of a graft versus leukaemia (GvL) effect in eradicating leukaemia was suggested as early as 1957, when Barnes and colleagues showed in a murine model that leukaemic animals which received myeloablative radiotherapy followed by syngeneic bone marrow transplant all relapsed with the original acute leukaemia and died; in contrast, animals receiving the same radiotherapy but allogeneic bone marrow transplant all developed fatal graft-versus-hot disease (GvHD).
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