Immunotherapy as a cancer treatment modality has undergone recent widespread proliferation across all cancer types, especially amongst patients with solid tumors. However, the longest tenured immunotherapy approach to cancer is allogeneic stem cell transplantation (allo-SCT) for two hematologic malignancies: acute myeloid and acute lymphoid leukemia (AML and ALL, respectively). While allo-SCT remains a standard of care for eligible patients, recent advances/applications of monoclonal antibodies, immune checkpoint inhibitors, bispecific T-cell engagers (BiTEs), and CAR T-cell therapy are changing the treatment landscape for these acute leukemias by either direct to tumor immune targeting or through decreased toxicities that expand patient eligibility. Pre-clinical data and clinical trials have shown promising results for novel immunotherapies in acute leukemia, and multiple ongoing trials are investigating these novel approaches. While there have been promising results with these approaches, particularly in the relapsed/refractory setting, there remain challenges in optimizing the use of these therapies, such as managing cytokine release syndrome and other immune-related toxicities. Immunotherapy is a rapidly evolving field in the treatment of acute leukemia and has the potential to significantly impact the management of both AML and ALL. This review highlights the history of immunotherapy in the treatment of acute leukemias, the evolution of immunotherapy into more targeted approaches, the potential benefits and limitations of different immune targeting approaches, and ongoing research and development in the field.
作为一种癌症治疗手段，免疫疗法近年来已在所有癌症类型中广泛应用，尤其在实体瘤患者中更为普遍。然而，历史最悠久的癌症免疫疗法当属针对两种血液系统恶性肿瘤——急性髓系白血病和急性淋巴细胞白血病（分别为AML和ALL）进行的异基因干细胞移植。尽管异基因干细胞移植仍是符合条件患者的标准化治疗方案，但单克隆抗体、免疫检查点抑制剂、双特异性T细胞衔接器以及CAR-T细胞疗法的最新进展与应用，正通过直接靶向肿瘤免疫或降低治疗毒性以扩大患者适用范围，改变着这些急性白血病的治疗格局。临床前数据及临床试验已显示新型免疫疗法在急性白血病治疗中前景广阔，目前多项进行中的试验正在探索这些创新方法。尽管这些疗法（尤其在复发/难治性病例中）已展现出积极疗效，但在优化治疗方案方面仍存在挑战，例如细胞因子释放综合征及其他免疫相关毒性的管理。免疫疗法是急性白血病治疗领域中快速发展的方向，有望对AML和ALL的临床管理产生重大影响。本综述重点阐述免疫疗法在急性白血病治疗中的发展历程、向精准靶向治疗的演进过程、不同免疫靶向策略的潜在优势与局限，以及该领域当前的研究进展与发展方向。
Immunotherapy in Acute Leukemias: Past Success Paves the Way for Future Progress
肿瘤(癌症)患者之家