盐酸组胺与低剂量白细胞介素-2在急性髓系白血病复发预防新领域中的应用

Histamine dihydrochloride and low-dose interleukin-2 in an emerging landscape of relapse prevention in acute myeloid leukemia.

作者信息

Nilsson Malin S, Martner Anna, Wennström Lovisa, Hansson Markus, Thorén Fredrik B, Hellstrand Kristoffer

机构信息

TIMM Laboratory, Sahlgrenska Center for Cancer Research, University of Gothenburg, Gothenburg, Sweden.

Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

Ther Adv Hematol. 2025 Jun 28;16:20406207251351086. doi: 10.1177/20406207251351086. eCollection 2025.

Abstract

Effective strategies to maintain complete remission in adults with acute myeloid leukemia (AML) are critically needed. Early clinical trials aimed at preventing relapse in the postconsolidation phase explored prolonged chemotherapy, single-agent immunotherapy, and hybrid chemo-immunotherapy, but none of these approaches produced practice-changing results. More recent trials have identified efficacious remission maintenance strategies, including (1) midostaurin or quizartinib for patients with -mutated AML, (2) oral azacitidine for older AML patients, and (3) immunotherapy with histamine dihydrochloride and low-dose interleukin-2 (HDC/IL-2) for younger patients. In this review, we examine key phase III trial and follow-up study results for approved remission maintenance therapies, with a particular focus on HDC/IL-2. We discuss clinical efficacy in relation to patient age and anti-leukemic immunity as well as leukemic cell chemosensitivity, chromosomal integrity, and mutational profiles. Finally, we propose a role for HDC/IL-2 within an evolving landscape of strategies to achieve durable remission in a broader population of AML patients.

摘要

迫切需要有效的策略来维持成人急性髓系白血病(AML)的完全缓解。早期旨在预防巩固治疗后复发的临床试验探索了延长化疗、单药免疫治疗和混合化疗免疫治疗,但这些方法均未产生改变临床实践的结果。最近的试验确定了有效的缓解维持策略,包括:(1)对于携带 FLT3 突变的 AML 患者使用米哚妥林或奎扎替尼;(2)对于老年 AML 患者使用口服阿扎胞苷;(3)对于年轻患者使用二盐酸组胺和低剂量白细胞介素-2(HDC/IL-2)进行免疫治疗。在本综述中,我们研究了已获批的缓解维持疗法的关键 III 期试验和随访研究结果,尤其关注 HDC/IL-2。我们讨论了与患者年龄、抗白血病免疫以及白血病细胞化学敏感性、染色体完整性和突变谱相关的临床疗效。最后,我们提出 HDC/IL-2 在不断发展的策略格局中的作用,以便在更广泛的 AML 患者群体中实现持久缓解。

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