Gbolahan Olumide Babajide, Zeidan Amer M, Stahl Maximilian, Abu Zaid Mohammad, Farag Sherif, Paczesny Sophie, Konig Heiko
Department of Medicine, Division of Hematology/Oncology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Department of Medicine, Section of Hematology, Yale University School of Medicine, New Haven, CT 06510, USA.
Int J Mol Sci. 2017 Jul 31;18(8):1660. doi: 10.3390/ijms18081660.
Intensive chemotherapeutic protocols and allogeneic stem cell transplantation continue to represent the mainstay of acute myeloid leukemia (AML) treatment. Although this approach leads to remissions in the majority of patients, long-term disease control remains unsatisfactory as mirrored by overall survival rates of approximately 30%. The reason for this poor outcome is, in part, due to various toxicities associated with traditional AML therapy and the limited ability of most patients to tolerate such treatment. More effective and less toxic therapies therefore represent an unmet need in the management of AML, a disease for which therapeutic progress has been traditionally slow when compared to other cancers. Several studies have shown that leukemic blasts elicit immune responses that could be exploited for the development of novel treatment concepts. To this end, early phase studies of immune-based therapies in AML have delivered encouraging results and demonstrated safety and feasibility. In this review, we discuss opportunities for immunotherapeutic interventions to enhance the potential to achieve a cure in AML, thereby focusing on the role of monoclonal antibodies, hypomethylating agents and the leukemic microenvironment.
强化化疗方案和异基因干细胞移植仍然是急性髓系白血病（AML）治疗的主要手段。尽管这种方法能使大多数患者获得缓解，但长期疾病控制仍不尽人意，总体生存率约为30%就反映了这一点。这种不良预后的部分原因是与传统AML治疗相关的各种毒性，以及大多数患者耐受此类治疗的能力有限。因此，更有效且毒性更小的疗法是AML治疗中尚未满足的需求，与其他癌症相比，AML的治疗进展传统上一直较为缓慢。多项研究表明，白血病原始细胞会引发免疫反应，可用于开发新的治疗理念。为此，AML基于免疫疗法的早期研究取得了令人鼓舞的结果，并证明了其安全性和可行性。在本综述中，我们讨论免疫治疗干预的机会，以提高治愈AML的可能性，从而重点关注单克隆抗体、低甲基化药物和白血病微环境的作用。
