Keeping the baby but not the bathwater
The reconstituted immune system of an allogeneic hematopoietic cell transplant patient is responsible for preventing leukemia relapse by means of graft-versus-leukemia (GvL) activity. This same reconstituted immune system can turn on the recipient in the form of graft-versus-host disease (GvHD). Tugues et al. used multiple mouse transplant models to decipher the mechanisms driving GvHD and GvL. They discovered that GM-CSF–activated myeloid cells mediated GvHD, but did not contribute to GvL, which is largely carried out by T cells. These results suggest that blocking GM-CSF in hematopoietic cell transplant recipients may be able to specifically target cells that promote GvHD, without hampering those that enact GvL.
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