Roshandel Elham, Tavakoli Farzaneh, Parkhideh Sayeh, Akhlaghi Sedigheh Sadat, Ardakani Maria Tavakoli, Soleimani Masoud
Hematopoietic Stem Cell Research Center Shahid Beheshti University of Medical Sciences Tehran Iran.
Department of Internal Medicine, School of Medicine, Ayatollah Taleghani Hospital Shahid Beheshti University of Medical Sciences Tehran Iran.
Health Sci Rep. 2022 Mar 8;5(2):e536. doi: 10.1002/hsr2.536. eCollection 2022 Mar.
Despite the revolutionary effects of hematopoietic stem cell transplantation (HSCT) in treating hematological malignancies, post-HSCT relapse is considered a critical concern of clinicians. Residual malignant cells employ many mechanisms to evade immune surveillance and survive to cause relapse after transplantation. One of the immune-frustrating mechanisms through which malignant cells can compromise the antitumor effects is misusing the self-limiting system of immune response by overexpressing inhibitory molecules to interact with the immune cells, leading them to so-called "exhausted" and ineffective. Introduction of these molecules, known as immune checkpoints, and blocking them was a prodigious step to decrease the relapses.
Using keywords , , and , we investigated the literature to figure out the role of the immune checkpoints in the HSCT setting. Studies in which these agents were administrated for relapse after transplantation were reviewed. Factors such as the interval from the transplant to relapse, previous treatment history, adverse events, and the patients' outcome were extracted.
Here we provided a mini-review discussing the experiences of three immune checkpoints, including nivolumab, pembrolizumab, and ipilimumab, as well as the pros and cons of using their blockers in relapse control after HSCT. In conclusion, it seems that CI therapy seems effective for this population. Future investigations may provide detailed outlook of this curative options.
尽管造血干细胞移植（HSCT）在治疗血液系统恶性肿瘤方面具有革命性作用，但HSCT后复发仍是临床医生极为关注的问题。残留的恶性细胞采用多种机制逃避免疫监视并存活下来，导致移植后复发。恶性细胞能够破坏抗肿瘤作用的一种免疫抑制机制是通过过度表达抑制性分子与免疫细胞相互作用，滥用免疫反应的自我限制系统，导致免疫细胞进入所谓的“耗竭”状态且失去效力。引入这些被称为免疫检查点的分子并对其进行阻断，是减少复发的一项重大举措。
我们使用关键词 、 和 ，检索文献以明确免疫检查点在HSCT环境中的作用。对这些药物用于移植后复发治疗的研究进行了综述。提取了从移植到复发的时间间隔、既往治疗史、不良事件以及患者预后等因素。
在此我们提供一篇小型综述，讨论三种免疫检查点，即纳武单抗、帕博利珠单抗和伊匹木单抗的应用经验，以及在HSCT后复发控制中使用其阻断剂的利弊。总之，CI疗法似乎对该人群有效。未来的研究可能会提供这种治疗选择的详细前景。
