Guo Xuege, Zhang Hanlu, Wang Xiao, Li Lijuan, Zhang Liansheng
Department of Hematology, The Second Hospital and Clinical Medical School, Lanzhou University, Lanzhou, China.
Gansu Provincial Hematology Clinical Medical Research Center (National Branch), The Second Hospital of Lanzhou University, Lanzhou, China.
Front Immunol. 2025 Aug 11;16:1635111. doi: 10.3389/fimmu.2025.1635111. eCollection 2025.
Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy driven by diverse genetic mutations that shape tumor progression, immune evasion, and clinical outcomes. While molecular profiling has improved AML classification, the precise impact of specific mutations on immune cell infiltration and dysregulation remains insufficiently understood. This review examines the immunologic consequences of common AML mutations-including , , , , , and -and their role in remodeling the immune microenvironment. We further explore the dynamic shifts in immune responses across different AML risk stratifications, emphasizing the balance between immune activation and suppression, which is influenced by specific genetic alterations. Additionally, we highlight the emerging potential of immunotherapies targeting neoepitopes derived from driver mutations, offering promising avenues to overcome immune escape and enhance anti-tumor immune responses. By integrating genetic mutations and immunologic insights, this review outlines a framework for developing more precise and effective immunotherapies for AML.
急性髓系白血病(AML)是一种异质性血液系统恶性肿瘤,由多种基因突变驱动,这些突变影响肿瘤进展、免疫逃逸和临床结局。虽然分子谱分析改进了AML的分类,但特定突变对免疫细胞浸润和失调的确切影响仍未得到充分了解。本综述探讨了常见AML突变(包括[此处原文缺失具体突变名称]、[此处原文缺失具体突变名称]、[此处原文缺失具体突变名称]、[此处原文缺失具体突变名称]、[此处原文缺失具体突变名称]和[此处原文缺失具体突变名称])的免疫后果及其在重塑免疫微环境中的作用。我们进一步探讨了不同AML风险分层中免疫反应的动态变化,强调了免疫激活与抑制之间的平衡,这种平衡受特定基因改变的影响。此外,我们强调了针对驱动基因突变衍生的新抗原的免疫疗法的新兴潜力,为克服免疫逃逸和增强抗肿瘤免疫反应提供了有前景的途径。通过整合基因突变和免疫学见解,本综述概述了为AML开发更精确和有效免疫疗法的框架。