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Review
. 2024 Dec;103(12):4883-4899.
doi: 10.1007/s00277-024-06117-9. Epub 2024 Nov 28.

Immunosuppressive microenvironment in acute myeloid leukemia: overview, therapeutic targets and corresponding strategies

Chenyu Zha  1   2 , Xinyu Yang  1   2 , Jun Yang  1   2 , Yujie Zhang  1 , Rui Huang  3
Affiliations
Review

Immunosuppressive microenvironment in acute myeloid leukemia: overview, therapeutic targets and corresponding strategies

Chenyu Zha et al. Ann Hematol. 2024 Dec.

Abstract

Similar to other malignancies, immune dysregulation is a key feature of acute myeloid leukemia (AML), manifesting as suppressed anti-leukemia immune cells, immune evasion by leukemia blasts, and disease progression. Various immunosuppressive factors within the AML microenvironment contribute to the weakening of host immune responses and the efficacy of cellular immunotherapy. To address these challenges, strategies targeting immunosuppressive elements within the AML microenvironment aim to bolster host or adoptive immune effector cells, ultimately enhancing leukemia treatment. Additionally, the off-target effects of certain targeted drugs (venetoclax, sorafenib, ivosidenib, etc.) may also positively impact anti-AML immunity and immunotherapy. This review provides an overview of the immunosuppressive factors present in AML microenvironment and the strategies developed to rescue immune cells from immunosuppression. We also outline how targeted agents can alter the immune landscape in AML patients, and discuss the potential of targeted drugs to benefit host anti-leukemia immunity and immunotherapy for AML.

Keywords: Acute myeloid leukemia; Immunosuppression; Immunotherapy; Targeted therapy.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

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