The Elephant in The Room: AML Relapse Post Allogeneic Hematopoietic Cell Transplantation
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Frontiers Media S.A.
Abstract
Relapsed acute myeloid leukemia (AML) following allogeneic hematopoietic cell transplantation (allo-HCT) is an unfavorable event associated with a poor prognosis, particularly for patients with early relapses. It usually arises from resistant leukemic blasts that escaped both preparative chemotherapy regimen and the graft-versus-leukemia (GVL) effect. Independent from the choice of salvage treatment, only minority of patients can achieve durable remissions. In recent years, better understanding of the disease relapse biology post allo-HCT allowed the application of newer strategies that could induce higher rates of remission, and potential longer survival. Those strategies aim at optimizing drugs that have a direct anti-leukemia activity by targeting different oncogenic mutations, metabolism pathways or surface antigens, and concurrently enhancing the immune microenvironment to promote GVL effect. This review discusses the current treatment landscape of AML relapse post allo-HCT. Copyright © 2022 Abou Dalle, Atoui and Bazarbachi.
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Allotransplant, Aml, Graft versus leukaemia (gvl), Immunotherapy, Relapse, Cd135 antigen, Cd33 antigen, Chimeric antigen receptor, Cytotoxic t lymphocyte antigen 4, Hla dqb1 antigen, Hla drb1 antigen, Immune checkpoint inhibitor, Interleukin 15, Isocitrate dehydrogenase 1, Membrane antigen, Programmed death 1 receptor, Protein bcl 2, Stat5 protein, Thymocyte antibody, Transcription factor ezh2, Acute lymphoblastic leukemia, Acute myeloid leukemia, Adoptive immunotherapy, Allogeneic hematopoietic stem cell transplantation, Allograft, Antigen presenting cell, Antileukemic activity, Apoptosis, Autologous stem cell transplantation, Cancer chemotherapy, Cancer immunotherapy, Cancer prognosis, Cancer recurrence, Cancer survival, Cd8+ t lymphocyte, Cell nucleus inclusion body, Chemotherapy, Copy number variation, Cytogenetics, Cytotoxicity, Donor lymphocyte infusion, Down regulation, Flow cytometry, Graft versus leukemia effect, Haplotype, Hematopoietic stem cell, Hematopoietic stem cell transplantation, Human, Innate immunity, Karyotype, Lymphoblastoma, Metabolism, Microenvironment, Mutation, Myelodysplastic syndrome, Natural killer cell, Nonhuman, Overall survival, Progression free survival, Promyelocytic leukemia, Quality of life, Recurrence free survival, Recurrent disease, Regulatory t lymphocyte, Retrospective study, Review, Salvage therapy, Signal transduction, Tumor microenvironment, Tumor volume, Upregulation