[Antigen-specific allogeneic immunotherapy--selective augmentation of GVL effects]

Area of Science:

• Hematology
• Immunology
• Oncology

Context:

• Chemotherapy and molecular-targeted therapies have improved malignant tumor prognosis.
• Allogeneic hematopoietic cell transplantation (allo-HCT) remains the only curative option for chemotherapy-resistant hematological malignancies.
• Reduced intensity preconditioning regimens have expanded allo-HCT eligibility, including for elderly patients.

Purpose:

• To discuss current and future strategies for selectively enhancing graft-versus-leukemia (GVL) effects.
• To address the challenge of increasing GVL effects without inducing graft-versus-host disease (GVHD).

Summary:

• Advancements in chemotherapy and targeted therapy have improved outcomes for many cancers.
• Allo-HCT is crucial for chemotherapy-resistant hematological malignancies, with reduced intensity regimens broadening patient access.
• Despite these advances, survival for high-risk malignancies remains suboptimal, and enhancing donor immunity risks GVHD.

Impact:

• This review will provide insights into optimizing allo-HCT by selectively boosting anti-leukemia immunity.
• The discussion aims to guide future research toward improving GVL effects while mitigating GVHD, ultimately enhancing patient survival in hematological malignancies.