Li Feng, Yang Fei-Fei, Xu Yan-Li
Department of Hematology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, Jiangsu Province, China.
Department of Hematology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, Jiangsu Province, China.E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Oct;31(5):1569-1573. doi: 10.19746/j.cnki.issn.1009-2137.2023.05.050.
Although the body has a strong immune system which can resists the invasion of leukemia cells, leukemia cells disseminate systemically and form an immunosuppressive microenvironment through a variety of mechanisms, including regulation of antigen presentation, utilization of immunosuppressive enzyme AXL, immune cell inhibitory checkpoint NKG2A and immunoregulatory gene , resulting in immune escape. Therefore, most types of leukemia are inevitable for the affliction of drug resistance or relapse, and the immune efficacy is not as significant as that of other hematological tumors and the prognosis is suboptimal. This article reviews the immune heterogeneity of leukemia microenvironment from many aspects, including anti-leukemia immunity and immune escape. In addition, it also reviews the latest progress and future prospects of immune checkpoint inhibition, adoptive cell therapy and vaccine therapy in leukemia, providing a theoretical basis for the development of personalized combination therapy strategies with less toxic side effects.
尽管机体拥有强大的免疫系统，能够抵抗白血病细胞的侵袭，但白血病细胞会通过多种机制全身播散并形成免疫抑制微环境，这些机制包括调节抗原呈递、利用免疫抑制酶AXL、免疫细胞抑制性检查点NKG2A以及免疫调节基因，从而导致免疫逃逸。因此，大多数类型的白血病不可避免地会出现耐药或复发，其免疫疗效不如其他血液肿瘤显著，预后也不理想。本文从多个方面综述了白血病微环境的免疫异质性，包括抗白血病免疫和免疫逃逸。此外，还综述了免疫检查点抑制、过继性细胞疗法和疫苗疗法在白血病治疗中的最新进展和未来前景，为开发毒性较小的个性化联合治疗策略提供理论依据。
