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Review
. 2021 Dec 13;13(24):6246.
doi: 10.3390/cancers13246246.

Immunotherapy as a Turning Point in the Treatment of Acute Myeloid Leukemia

Anna Aureli  1 , Beatrice Marziani  2 , Tommaso Sconocchia  3 , Maria Ilaria Del Principe  4 , Elisa Buzzatti  4 , Gianmario Pasqualone  4 , Adriano Venditti  4 , Giuseppe Sconocchia  1
Affiliations
Review

Immunotherapy as a Turning Point in the Treatment of Acute Myeloid Leukemia

Anna Aureli et al. Cancers (Basel). .

Abstract

Acute myeloid leukemia (AML) is a malignant disease of hematopoietic precursors at the earliest stage of maturation, resulting in a clonalproliferation of myoblasts replacing normal hematopoiesis. AML represents one of the most common types of leukemia, mostly affecting elderly patients. To date, standard chemotherapy protocols are only effective in patients at low risk of relapse and therapy-related mortality. The average 5-year overall survival (OS) is approximately 28%. Allogeneic hematopoietic stem cell transplantation (HSCT) improves prognosis but is limited by donor availability, a relatively young age of patients, and absence of significant comorbidities. Moreover, it is associated with significant morbidity and mortality. However, increasing understanding of AML immunobiology is leading to the development of innovative therapeutic strategies. Immunotherapy is considered an attractive strategy for controlling and eliminating the disease. It can be a real breakthrough in the treatment of leukemia, especially in patients who are not eligible forintensive chemotherapy. In this review, we focused on the progress of immunotherapy in the field of AML by discussing monoclonal antibodies (mAbs), immune checkpoint inhibitors, chimeric antigen receptor T cells (CAR-T cells), and vaccine therapeutic choices.

Keywords: AML; antibody; antibody–drug conjugate; immunotherapy; targeted therapies.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Immunotargeting of validated targets in AML: approved versus investigational molecules. CD33 targeting: GO (Gentuzumabozogamicin) for favorable and intermediate AML in association with daunorubicine and cytarabine; SGN-CD33A and AMG-330 under investigation. CD123 targeting: tagraxofusp approved; SGN-123A, flotetuzumab, and JNJ63709178 investigational. The figure was created with BioRender.com.
Figure 2
Figure 2
CAR-T immunotherapy. (1) Patient’s T cells are collected by leukapheresis. (2) A viral vector delivers a gene encoding a CAR into the T cells. (3) Expansion of CAR-expressing T cells. (4)The CAR-T cells are infused into the patient’s blood (5). CAR-T cells attack cancer cells. The figure was created with BioRender.com.
Figure 3
Figure 3
Schematic representation of T cell responses toward AML tumor-associated antigen (TAA). DCs present the MHC, loaded with AML antigen peptides, to the TCR of T lymphocytes, allowing the generation of AML-specific Tcell activation and expansion. Among AML-specific T cells, CTL will be able to recognize and kill AML cells. The figure was created with BioRender.com.
See this image and copyright information in PMC

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