Acute myeloid leukaemia and the immune system: implications for immunotherapy

The recognition of the curative potential of the graft-versus-leukaemia effect for patients with acute myeloid leukaemia (AML) undergoing stem cell transplantation, and the emergence of immunotherapy as a powerful weapon to treat cancer, has spurred the exploration of the immune landscape of AML to apply immunotherapeutic approaches to curing the disease. While current concepts of cancer immunology and immunotherapy have relevance, there are also unique aspects of immune dysregulation in AML to be considered when designing rational immunotherapy for this leukaemia. This is timely because rapid advances in cancer immunobiology, together with technological developments have opened up the field of immunotherapy for malignant disease. Here the current knowledge of AML immunobiology is summarized together with a description of new immunotherapies to counter immunosuppression and immune evasion by AML. Recent advances in treatment with recombinant antibodies, adoptive cell therapy and vaccines and their future promise in AML treatment are reviewed.