Immune Escape after Hematopoietic Stem Cell Transplantation (HSCT): From Mechanisms to Novel Therapies
Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults. Recent advances in understanding its molecular basis have opened the way to new therapeutic strategies, including targeted therapies. However, despite an improvement in prognosis it has been documented in recent years...
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| Format: | Article |
| Language: | English |
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MDPI AG
2019-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/1/69 |
| _version_ | 1797761948658434048 |
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| author | Paolo Bernasconi Oscar Borsani |
| author_facet | Paolo Bernasconi Oscar Borsani |
| author_sort | Paolo Bernasconi |
| collection | DOAJ |
| description | Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults. Recent advances in understanding its molecular basis have opened the way to new therapeutic strategies, including targeted therapies. However, despite an improvement in prognosis it has been documented in recent years (especially in younger patients) that allogenic hematopoietic stem cell transplantation (allo-HSCT) remains the only curative treatment in AML and the first therapeutic option for high-risk patients. After allo-HSCT, relapse is still a major complication, and is observed in about 50% of patients. Current evidence suggests that relapse is not due to clonal evolution, but instead to the ability of the AML cell population to escape immune control by a variety of mechanisms including the altered expression of HLA-molecules, production of anti-inflammatory cytokines, relevant metabolic changes and expression of immune checkpoint (ICP) inhibitors capable of “switching-off” the immune response against leukemic cells. Here, we review the main mechanisms of immune escape and identify potential strategies to overcome these mechanisms. |
| first_indexed | 2024-03-12T19:20:22Z |
| format | Article |
| id | doaj.art-e21b4f6372694ea08ac1a6b6a1e38880 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-12T19:20:22Z |
| publishDate | 2019-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e21b4f6372694ea08ac1a6b6a1e388802023-08-02T05:13:43ZengMDPI AGCancers2072-66942019-12-011216910.3390/cancers12010069cancers12010069Immune Escape after Hematopoietic Stem Cell Transplantation (HSCT): From Mechanisms to Novel TherapiesPaolo Bernasconi0Oscar Borsani1Department of Molecular Medicine, University of Pavia, 27100 Pavia, ItalyDepartment of Molecular Medicine, University of Pavia, 27100 Pavia, ItalyAcute myeloid leukemia (AML) is the most common type of acute leukemia in adults. Recent advances in understanding its molecular basis have opened the way to new therapeutic strategies, including targeted therapies. However, despite an improvement in prognosis it has been documented in recent years (especially in younger patients) that allogenic hematopoietic stem cell transplantation (allo-HSCT) remains the only curative treatment in AML and the first therapeutic option for high-risk patients. After allo-HSCT, relapse is still a major complication, and is observed in about 50% of patients. Current evidence suggests that relapse is not due to clonal evolution, but instead to the ability of the AML cell population to escape immune control by a variety of mechanisms including the altered expression of HLA-molecules, production of anti-inflammatory cytokines, relevant metabolic changes and expression of immune checkpoint (ICP) inhibitors capable of “switching-off” the immune response against leukemic cells. Here, we review the main mechanisms of immune escape and identify potential strategies to overcome these mechanisms.https://www.mdpi.com/2072-6694/12/1/69acute myeloid leukemiahematopoietic stem cell transplantationrelapsedonor lymphocyte infusionhypomethylating agentsmechanisms of immune escape |
| spellingShingle | Paolo Bernasconi Oscar Borsani Immune Escape after Hematopoietic Stem Cell Transplantation (HSCT): From Mechanisms to Novel Therapies Cancers acute myeloid leukemia hematopoietic stem cell transplantation relapse donor lymphocyte infusion hypomethylating agents mechanisms of immune escape |
| title | Immune Escape after Hematopoietic Stem Cell Transplantation (HSCT): From Mechanisms to Novel Therapies |
| title_full | Immune Escape after Hematopoietic Stem Cell Transplantation (HSCT): From Mechanisms to Novel Therapies |
| title_fullStr | Immune Escape after Hematopoietic Stem Cell Transplantation (HSCT): From Mechanisms to Novel Therapies |
| title_full_unstemmed | Immune Escape after Hematopoietic Stem Cell Transplantation (HSCT): From Mechanisms to Novel Therapies |
| title_short | Immune Escape after Hematopoietic Stem Cell Transplantation (HSCT): From Mechanisms to Novel Therapies |
| title_sort | immune escape after hematopoietic stem cell transplantation hsct from mechanisms to novel therapies |
| topic | acute myeloid leukemia hematopoietic stem cell transplantation relapse donor lymphocyte infusion hypomethylating agents mechanisms of immune escape |
| url | https://www.mdpi.com/2072-6694/12/1/69 |
| work_keys_str_mv | AT paolobernasconi immuneescapeafterhematopoieticstemcelltransplantationhsctfrommechanismstonoveltherapies AT oscarborsani immuneescapeafterhematopoieticstemcelltransplantationhsctfrommechanismstonoveltherapies |