Jewish General Hospital, McGill University, Montreal, Québec, Canada.
Expert Rev Hematol. 2023 Jul-Dec;16(11):819-834. doi: 10.1080/17474086.2023.2268273. Epub 2023 Nov 17.
Myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) are generally characterized by a poor prognosis with currently available therapies. Immunotherapies have already seen success in treating a variety of malignant disorders, and their role in managing myeloid cancers is evolving rapidly.
This is a review of the immunotherapies tested in MDS and AML, including immune checkpoint inhibitors, bispecific antibodies, and cell therapies such as chimeric antigen receptor (CAR) T cell therapy, T cell receptor (TCR) engineered T cells, and natural killer (NK) cells, with a focus on clinical trials conducted to date and future directions.
Initial clinical trials exploring checkpoint inhibitors in MDS and AML have demonstrated high toxicity and disappointing efficacy. However, ongoing trials adding novel checkpoint inhibitors to standard therapy are more promising. Technological advances are improving the outlook for bispecific antibodies, and cellular therapies like adoptive NK cell infusion have favorable efficacy and tolerability in early trials. As our understanding of the immune microenvironment in MDS and AML improves, the role for immunotherapy in the treatment of these diseases will become clearer.
骨髓增生异常综合征（MDS）和急性髓系白血病（AML）通常具有较差的预后，目前的治疗方法效果有限。免疫疗法已经在治疗多种恶性疾病方面取得了成功，其在治疗髓系癌症方面的作用正在迅速发展。
这是一篇关于 MDS 和 AML 中测试的免疫疗法的综述，包括免疫检查点抑制剂、双特异性抗体以及嵌合抗原受体（CAR）T 细胞疗法、T 细胞受体（TCR）工程化 T 细胞和自然杀伤（NK）细胞等细胞疗法，重点介绍了迄今为止进行的临床试验和未来的发展方向。
最初在 MDS 和 AML 中探索检查点抑制剂的临床试验显示出高毒性和令人失望的疗效。然而，目前正在进行的将新型检查点抑制剂添加到标准治疗中的试验则更有希望。技术进步正在改善双特异性抗体的前景，而在早期试验中，过继性 NK 细胞输注等细胞疗法具有良好的疗效和耐受性。随着我们对 MDS 和 AML 中免疫微环境的理解的提高，免疫疗法在这些疾病治疗中的作用将变得更加清晰。
