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Review
. 2018 Apr 10;10(4):114.
doi: 10.3390/cancers10040114.

Immune Response against ALK in Children with ALK-Positive Anaplastic Large Cell Lymphoma

Serena Stadler  1 , Vijay Kumar Singh  2 , Fabian Knörr  3 , Christine Damm-Welk  4 , Wilhelm Woessmann  5
Affiliations
Review

Immune Response against ALK in Children with ALK-Positive Anaplastic Large Cell Lymphoma

Serena Stadler et al. Cancers (Basel). .

Abstract

Patients with anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) mount a humoral and cellular immune response against ALK. More than 90% of children and adolescents with ALK-positive ALCL have detectable anti-ALK antibodies in serum or plasma, and the antibody titer inversely correlates with the risk of relapse. ALK-specific CD8 and CD4 T cell responses have been described in patients with ALK-positive ALCL. Vaccination with ALK DNA led to protection against lymphoma growth in a murine model. Collectively, these data suggest that the ALK-specific immune response is involved in the control of the disease. The characteristics of the humoral and cellular immune response against ALK as well as tumor immune escape mechanisms have been increasingly investigated. However, tumor and host factors contributing to the individual immune response against ALK are still largely unknown. Depending on the individual strength of the immune response and its determinants, individualized immunological approaches might be appropriate for the consolidation of ALCL patients. Strategies such as ALK vaccination could be effective for those with a pre-existing anti-tumor immunity, while an allogeneic blood stem cell transplantation or check-point inhibition could be effective for others.

Keywords: ALK; ALK autoantibodies; ALK-positive ALCL; ALK-specific T cells; anaplastic large cell lymphoma; immune response.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Current understanding of the immune response against anaplastic lymphoma kinase (ALK) in patients with ALK-positive anaplastic large cell lymphoma (ALCL). On the left, the primary anti-tumor response is shown. ALK (red squares) is processed and presented by dendritic cells (DCs) to cells of the adaptive immune system. Cytokines (small circles) and other factors shape the type of the immune response. Long-term remission is characterized by the presence of an immunologic memory. Putative mechanisms and factors that could lead to immune escape and relapse are shown in the lower right.
Figure 2
Figure 2
Cumulative incidence of relapse of patients with ALK-positive ALCL according to the anti-ALK antibody titer (adapted from Reference [47]).
See this image and copyright information in PMC

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