Suicide gene therapy and the control of graft-vs-host disease

Allogeneic bone marrow transplantation as a cure for leukaemia and lymphoma is limited by the development of graft-vs-host disease (GVHD), an immunological reaction of the donorʹs T lymphocytes against the hostʹs normal tissues. One therapeutic option to treat GVHD is the transfer of ‘suicide’ genes into the donorʹs T lymphocytes to render them susceptible to prodrug administration. This procedure should permit the elimination of unwanted T lymphocytes in GVHD. The main genes proposed for such a strategy will be described in this chapter, together with the advantages and limitations found during preclinical and clinical studies to date