Immune escape and immunotherapy of acute myeloid leukemia
Luca Vago1,2 and Ivana Gojo3
1Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Disease, and
2Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy.
3Division of Hematologic Malignancies, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA.
Address correspondence to: Luca Vago, Unit of Immunogenetics, Leukemia Genomics and Immunobiology, IRCCS San Raffaele Scientific Institute, via Olgettina, 60, Milano, 20132, Italy. Phone: 390226434341; Email: vago.luca@hsr.it. Or to: Ivana Gojo, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, CRB1; Room 346, 1650 Orleans Street, Baltimore, Maryland 21287, USA. Phone: 410.502.8775; Email: igojo1@jhmi.edu.
Find articles by Vago, L. in: JCI | PubMed | Google Scholar
1Unit of Immunogenetics, Leukemia Genomics and Immunobiology, Division of Immunology, Transplantation and Infectious Disease, and
2Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy.
3Division of Hematologic Malignancies, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA.
Address correspondence to: Luca Vago, Unit of Immunogenetics, Leukemia Genomics and Immunobiology, IRCCS San Raffaele Scientific Institute, via Olgettina, 60, Milano, 20132, Italy. Phone: 390226434341; Email: vago.luca@hsr.it. Or to: Ivana Gojo, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, CRB1; Room 346, 1650 Orleans Street, Baltimore, Maryland 21287, USA. Phone: 410.502.8775; Email: igojo1@jhmi.edu.
Find articles by Gojo, I. in: JCI | PubMed | Google Scholar
First published April 1, 2020 - More info
J Clin Invest. 2020;130(4):1552–1564. https://doi.org/10.1172/JCI129204.
© 2020 American Society for Clinical Investigation
In spite of the recent approval of new promising targeted therapies, the clinical outcome of patients with acute myeloid leukemia (AML) remains suboptimal, prompting the search for additional and synergistic therapeutic rationales. It is increasingly evident that the bone marrow immune environment of AML patients is profoundly altered, contributing to the severity of the disease but also providing several windows of opportunity to prompt or rewire a proficient antitumor immune surveillance. In this Review, we present current evidence on immune defects in AML, discuss the challenges with selective targeting of AML cells, and summarize the clinical results and immunologic insights from studies that are testing the latest immunotherapy approaches to specifically target AML cells (antibodies, cellular therapies) or more broadly reactivate antileukemia immunity (vaccines, checkpoint blockade). Given the complex interactions between AML cells and the many components of their environment, it is reasonable to surmise that the future of immunotherapy in AML lies in the rational combination of complementary immunotherapeutic strategies with chemotherapeutics or other oncogenic pathway inhibitors. Identifying reliable biomarkers of response to improve patient selection and avoid toxicities will be critical in this process.
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Copyright © 2020 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)