Immune checkpoint pathways: perspectives on myeloid malignancies.

Immunologic tolerance to cancer has recently been shown to have major implications for the ability of tumors to survive despite a variety of therapeutic approaches. A critical mechanism underlying this microenvironment dysfunction relates to the ability of tumor cells to block immune check points through expression of specific proteins that interfere with immune cell effector function. Recent advances based on this model have led translational work showing therapeutic efficacy in a variety of solid and lymphoid tumors. Myeloid malignancies, in particular myelodysplastic syndromes (MDS), have significant immune dysregulation of variable degree based on their clinical stages which makes feasible extending such therapeutic approaches to this group of diseases. This review will discuss recent advances in the field of immune checkpoint biology including recent clinical trials with checkpoint inhibitors in patients with a variety of clinical conditions, with focus on such potential therapy in patients with myeloid malignancies.