title: Immunotherapeutic strategies including transplantation: eradication of disease.
abstract: Although there have been recent advances with targeted therapies in chronic lymphocytic leukemia (CLL), chemoimmunotherapy remains the treatment of choice; however, this approach is not curative. A key feature of CLL is that it induces a state of immunosuppression, causing increased susceptibility to infections and failure of an antitumor immune response, often worsened by the immunosuppressive effect of treatment. Because of its improved specificity, immunotherapy potentially offers a way out of this dilemma. Allogeneic stem cell transplantation remains the only curative option, but is hampered by the toxicity of GVHD. After many years of promise but little reward, many other immunotherapeutic approaches are now in transition to the clinical setting. Clinical trials including CLL vaccines, CXCR4 antagonists, and adoptive cellular immunotherapies such as chimeric antigen receptor-modified T cells, CD40 ligand gene therapy, and the immunomodulatory drug lenalidomide are ongoing. Results to date suggest that immunotherapeutic approaches for the treatment of CLL might finally be fulfilling their promise.
authors: 1Barts Cancer Institute, Queen Mary University of London, London, United Kingdom.
authors: John G
authors: JG
authors: Gribben
authors: John C
authors: JC
authors: Riches
mesh_terms: D019264:Adoptive Transfer / Q000379:methods*; D064591:Allografts; D000970:Antineoplastic Agents / Q000627:therapeutic use; D023201:CD40 Ligand / Q000627:therapeutic use; D019496:Cancer Vaccines / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D006086:Graft vs Host Disease / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000276:immunology / Q000628:therapy*; D011948:Receptors, Antigen, T-Cell / Q000627:therapeutic use; D033581:Stem Cell Transplantation
chemical_list: D000970:Antineoplastic Agents; D019496:Cancer Vaccines; D011948:Receptors, Antigen, T-Cell; D023201:CD40 Ligand