University of Gothenburg, Guldhedsgatan 10B, 413 46 Göteborg, Sweden.
Expert Rev Hematol. 2010 Aug;3(4):381-91. doi: 10.1586/ehm.10.30.
Most patients with acute myeloid leukemia (AML) achieve complete remission (CR) after induction chemotherapy. Despite ensuing courses of consolidation chemotherapy, a large fraction of patients will experience relapses with poor prospects of long-term survival. Histamine dihydrochloride (HDC) in combination with the T-cell-derived cytokine IL-2 was recently approved within the EU as a remission maintenance immunotherapy in AML. HDC reduces myeloid cell-derived suppression of anti-leukemic lymphocytes, and aims to unravel a therapeutic benefit of IL-2 in AML by improving natural killer and T-cell activation. A randomized Phase III trial with 320 AML patients in CR demonstrated a significant reduction of relapse risk after immunotherapy with HDC plus low-dose IL-2 in the post-consolidation phase. HDC is the first approved therapeutic to target the state of immunosuppression in AML; further development in this area may comprise supplementary or alternative counter-suppressive agents with the aim to improve the efficacy of cancer immunotherapy.
大多数急性髓系白血病（AML）患者在诱导化疗后达到完全缓解（CR）。尽管随后进行了巩固化疗，但仍有很大一部分患者会复发，长期生存的前景不佳。盐酸组织胺（HDC）与 T 细胞衍生的细胞因子白细胞介素 2（IL-2）最近在欧盟被批准作为 AML 的缓解维持免疫疗法。HDC 降低了骨髓细胞来源对抗白血病淋巴细胞的抑制作用，旨在通过改善自然杀伤细胞和 T 细胞的激活来发挥 IL-2 在 AML 中的治疗益处。一项针对 320 例 AML 患者的随机 III 期试验显示，在巩固治疗后接受 HDC 联合低剂量 IL-2 的免疫治疗后，复发风险显著降低。HDC 是第一种针对 AML 免疫抑制状态的批准治疗药物；该领域的进一步发展可能包括补充或替代的抗抑制药物，以提高癌症免疫疗法的疗效。
