Yang Dan, Zhang Xiuqun, Zhang Xuezhong, Xu Yanli
Department of Hematology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, Jiangsu, People's Republic of China.
Ann Hematol. 2017 Dec;96(12):1965-1982. doi: 10.1007/s00277-017-3148-x. Epub 2017 Oct 28.
Recently, there has been remarkable progress in basic and preclinical studies of acute myeloid leukemia (AML). The improved outcomes of AML can largely be attributed to advances in supportive care and hematopoietic cell transplantation as opposed to conventional chemotherapy. However, as the 5-year survival rate remains low due to a high incidence of relapse, novel and effective treatments are urgently needed. Increasing attention is focusing on identifying suitable immunotherapeutic strategies for AML. Here, we describe the immunological features, mechanisms of immune escape, and recent progress in immunotherapy for AML. Problems encountered in the clinic will also be discussed. Although current outcomes may be limited, ongoing preclinical or clinical efforts are aimed at improving immunotherapy modalities and designing novel therapies, such as vaccines, monoclonal antibody therapy, chimeric antibody receptor-engineered T cells (CAR-T), TCR-engineered T cells (TCR-T), and checkpoint inhibitors, which may provide promising and effective therapies with higher specificity and efficacy for AML.
最近,急性髓系白血病(AML)的基础和临床前研究取得了显著进展。AML治疗效果的改善很大程度上归因于支持治疗和造血细胞移植的进展,而非传统化疗。然而,由于复发率高,5年生存率仍然很低,因此迫切需要新的有效治疗方法。越来越多的关注集中在为AML确定合适的免疫治疗策略上。在此,我们描述了AML的免疫特征、免疫逃逸机制以及免疫治疗的最新进展。还将讨论临床中遇到的问题。尽管目前的治疗效果可能有限,但正在进行的临床前或临床研究致力于改进免疫治疗方式并设计新的疗法,如疫苗、单克隆抗体疗法、嵌合抗原受体工程化T细胞(CAR-T)、T细胞受体工程化T细胞(TCR-T)和检查点抑制剂,这些可能为AML提供具有更高特异性和疗效的有前景且有效的治疗方法。