Immune reconstitution in chronic lymphocytic leukemia.
Chronic lymphocytic leukemia (CLL) is associated with a profound immune defect, which results in increased susceptibility to recurrent infections as well as a failure to mount effective antitumor immune responses. Current chemotherapy-based regimens are not curative and often worsen this immune suppression, so their usefulness is limited, particularly in the frail and elderly. This article reviews the immune defect in CLL and discusses strategies aimed at repairing or circumventing this defect. In particular, it focuses on recent developments in the areas of CD40 ligand (CD40L/CD154) gene therapy, immunomodulatory agents such as lenalidomide, and adoptive transfer of T cells bearing chimeric antigen receptors.
Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK. johnriches@doctors.org.uk
John C
JC
Riches
Alan G
AG
Ramsay
John G
JG
Gribben
D019264:Adoptive Transfer / Q000379:methods; D000970:Antineoplastic Agents / Q000627:therapeutic use; D023201:CD40 Ligand / Q000235:genetics / Q000502:physiology; D015316:Genetic Therapy / Q000379:methods; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D000077269:Lenalidomide; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000276:immunology* / Q000473:pathology / Q000628:therapy*; D013601:T-Lymphocytes / Q000637:transplantation; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use
D000970:Antineoplastic Agents; D023201:CD40 Ligand; D013792:Thalidomide; D000077269:Lenalidomide