Tricking the trickster: precision medicine approaches to counteract leukemia immune escape after transplant.
Blood
; 143(26): 2710-2721, 2024 Jun 27.
Article
in En
| MEDLINE
| ID: mdl-38728431
ABSTRACT
ABSTRACT Over the last decades, significant improvements in reducing the toxicities of allogeneic hematopoietic cell transplantation (allo-HCT) have widened its use as consolidation or salvage therapy for high-risk hematological malignancies. Nevertheless, relapse of the original malignant disease remains an open issue with unsatisfactory salvage options and limited rationales to select among them. In the last years, several studies have highlighted that relapse is often associated with specific genomic and nongenomic mechanisms of immune escape. In this review we summarize the current knowledge about these modalities of immune evasion, focusing on the mechanisms that leverage antigen presentation and pathologic rewiring of the bone marrow microenvironment. We present examples of how this biologic information can be translated into specific approaches to treat relapse, discuss the status of the clinical trials for patients who relapsed after a transplant, and show how dissecting the complex immunobiology of allo-HCT represents a crucial step toward developing new personalized approaches to improve clinical outcomes.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Leukemia
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Hematopoietic Stem Cell Transplantation
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Tumor Escape
/
Precision Medicine
Limits:
Humans
Language:
En
Journal:
Blood
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: