Immune therapy: a new therapy for acute myeloid leukemia

Abstract

Although complete remission could be achieved in about 60%-70% of acute myeloid leukemia (AML) patients after conventional chemotherapy, relapse and the state of being refractory to treatment remain the main cause of death. In addition, there is a great need for less intensive regimens for all medically frail patients (both due to age/comorbidity and treatment-related). Immune therapy anticipates improved prognosis and reduced toxicities, which may offer novel therapeutic rationales. However, one of the major difficulties in developing immune therapies against AML is that the target antigens are also significantly expressed on healthy hematopoietic stem cells; B-cell malignancies are different because CD20/CD19/healthy B-cells are readily replaceable. Only the anti-CD33 antibody-drug conjugate gemtuzumab-ozogamicin is approved by the FDA for AML. Thus, drug development remains extremely active, although it is still in its infancy. This review summarizes the clinical results of immune therapeutic agents for AML, such as antibody-based drugs, chimeric antigen receptor therapy, checkpoint inhibitors, and vaccines.

Keywords: Acute myeloid leukemia; Antibody-based drugs; Checkpoint inhibitors; Chimeric antigen receptor therapy; Vaccine.

Figure 1.

Schematic mechanism between immunotargeted drugs and AML cells. Ab = antibody, AML = acute myeloid leukemia, CAR = chimeric antigen receptor, CTLA-4 = cytotoxic T-lymphocyte-associated protein 4, IL-3 = interleukin-3, IL-3R = interleukin-3 receptor, NK = natural killer, PD-1 = programmed cell death 1, PD-L1 = programmed cell death ligand-1.