title: Immunotherapeutic strategies for relapse control in acute myeloid leukemia.
abstract: Despite that the initial phases of chemotherapy induce disappearance of leukemic cells in many patients with acute myeloid leukemia (AML), the prevention of life-threatening relapses in the post-remission phase remains a significant clinical challenge. Allogeneic bone marrow transplantation, which is available for a minority of patients, efficiently prevents recurrences of leukemia by inducing immune-mediated elimination of leukemic cells, and over the past decades, numerous immunotherapeutic protocols have been developed aiming to mimic the graft-versus-leukemia reaction for the prevention of relapse. Here we review past and present strategies for relapse control with focus on overcoming leukemia-related immunosuppression in AML. We envisage future treatment protocols, in which systemic immune activators, such as vaccines, dendritic cell-based therapies, engineered variants of IL-2, or IL-15, are combined with agents that counter immunosuppression mediated by, e.g., the PD/PDL interaction, CTLA-4, CD200, reactive oxygen species, IDO expression, CXCR4, or the KIR/class I interaction, based on characteristics of the prevailing malignant clone. This combinatorial approach may pave the way for individualized immunotherapy in AML.
authors.affiliation: Sahlgrenska Cancer Center, University of Gothenburg, Box 405, 40530 Gothenburg, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Martner
authors.forename: Fredrik Bergh
authors.initials: FB
authors.lastname: Thorén
authors.forename: Johan
authors.initials: J
authors.lastname: Aurelius
authors.forename: Kristoffer
authors.initials: K
authors.lastname: Hellstrand
mesh_terms: D000911:Antibodies, Monoclonal / Q000276:immunology / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D019496:Cancer Vaccines / Q000627:therapeutic use; D016207:Cytokines / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy; D015470:Leukemia, Myeloid, Acute / Q000276:immunology* / Q000473:pathology / Q000628:therapy*; D060046:Maintenance Chemotherapy; D055502:Secondary Prevention
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D019496:Cancer Vaccines; D016207:Cytokines
keywords: Acute myeloid leukemia; Leukemia-related immunosuppression; Maintenance therapy