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To determine whether graft-versus-leukemia (GVL) reactions are important in preventing leukemia recurrence after bone marrow transplantation, we studied 2,254 persons receiving HLA-identical sibling bone marrow transplants for acute myelogenous leukemia (AML) in first remission, acute lymphoblastic leukemia (ALL) in first remission, and chronic myelogenous leukemia (CML) in first chronic phase. Four groups were investigated in detail: recipients of non--T-cell depleted allografts without graft-versus-host disease (GVHD), recipients of non-- T-cell depleted allografts with GVHD, recipients of T-cell depleted allografts, and recipients of genetically identical twin transplants. Decreased relapse was observed in recipients of non--T-cell depleted allografts with acute (relative risk 0.68, P = .03), chronic (relative risk 0.43, P = .01), and both acute and chronic GVDH (relative risk 0.33, P = .0001) as compared with recipients of non--T-cell depleted allografts without GVHD. These data support an antileukemia effect of GVHD. AML patients who received identical twin transplants had an increased probability of relapse (relative risk 2.58, P = .008) compared with allograft recipients without GVHD. These data support an antileukemia effect of allogeneic grafts independent of GVHD. CML patients who received T-cell depleted transplants with or without GVHD had higher probabilities of relapse (relative risks 4.45 and 6.91, respectively, P = .0001) than recipients of non--T-cell depleted allografts without GVHD. These data support an antileukemia effect independent of GVHD that is altered by T-cell depletion. These results explain the efficacy of allogeneic bone marrow transplantation in eradicating leukemia, provide evidence for a role of the immune system in controlling human cancers, and suggest future directions to improve leukemia therapy. Volume 75, Issue 3, pp. 555-562, 02/01/1990 Copyright © 1990 by The American Society of Hematology CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: S. F. Cai, X. Cao, A. Hassan, T. A. Fehniger, and T. J. Ley Granzyme B is not required for regulatory T cell-mediated suppression of graft-versus-host disease Blood, March 4, 2010; 115(9): 1669 - 1677. [Abstract] [Full Text] [PDF] D. Sage My approach to the immunogenetics of haematopoietic stem cell transplant matching J. Clin. Pathol., March 1, 2010; 63(3): 194 - 198. [Abstract] [Full Text] [PDF] M. A. Biernacki, O. Marina, W. Zhang, F. Liu, I. Bruns, A. Cai, D. Neuberg, C. M. Canning, E. P. Alyea, R. J. Soiffer, et al. Efficacious Immune Therapy in Chronic Myelogenous Leukemia (CML) Recognizes Antigens That Are Expressed on CML Progenitor Cells Cancer Res., February 1, 2010; 70(3): 906 - 915. [Abstract] [Full Text] [PDF] H. Dohner, E. H. Estey, S. 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