Isidori Alessandro, Salvestrini Valentina, Ciciarello Marilena, Loscocco Federica, Visani Giuseppe, Parisi Sarah, Lecciso Mariangela, Ocadlikova Darina, Rossi Lara, Gabucci Elisa, Clissa Cristina, Curti Antonio
Haematology and Haematopoietic Stem Cell Transplant Center, AORMN Hospital, Via Lombroso, 1, 61122, Pesaro, Italy.
Expert Rev Hematol. 2014 Dec;7(6):807-18. doi: 10.1586/17474086.2014.958464. Epub 2014 Sep 16.
Functional interplay between acute myeloid leukemia (AML) cells and the bone marrow microenvironment is a distinctive characteristic of this hematological cancer. Indeed, a large body of evidence suggests that proliferation, survival and drug resistance of AML are sustained and modulated by the bone marrow immunosuppressive microenvironment, where both innate and adaptive immune responses are profoundly deregulated. Furthermore, the presence of a number of different immunosuppressive mechanisms results in massive immune deregulation, which causes the eventual escape from natural immune control. Modulating the immune system, as documented by 40 years of stem cell transplantation, may improve survival of AML patients, as the immune system is clearly able to recognize and attack leukemic cells. The understanding of the factors responsible for the escape from immune destruction in AML, which becomes more prominent with disease progression, is necessary for the development of innovative immunotherapeutic treatment modalities in AML.
急性髓系白血病（AML）细胞与骨髓微环境之间的功能相互作用是这种血液系统癌症的一个显著特征。确实，大量证据表明，AML的增殖、存活和耐药性由骨髓免疫抑制微环境维持和调节，在该微环境中，固有免疫和适应性免疫反应均受到严重失调。此外，多种不同免疫抑制机制的存在导致大量免疫失调，从而导致最终逃脱自然免疫控制。正如40年干细胞移植所证明的那样，调节免疫系统可能会提高AML患者的生存率，因为免疫系统显然能够识别并攻击白血病细胞。了解导致AML逃脱免疫破坏的因素（随着疾病进展，这一点变得更加突出）对于开发AML的创新免疫治疗方法至关重要。
