摘要
大多数急性髓系白血病(acute myeloid leukemia,AML)患者化疗诱导缓解后不可避免地面临复发。异基因造血干细胞移植作为AML最有效的治疗,通过免疫介导的移植物抗白血病效应根除白血病细胞,能有效预防AML复发。移植技术和单倍体移植模式进展使得"人人都能进行造血干细胞移植"。靶向治疗,如基因工程T细胞(嵌合抗原受体T细胞)、单克隆抗体、新型双特异性单抗,能特异性杀伤表达特殊抗原的白血病细胞,而不伤害正常细胞,将成为AML免疫治疗的新策略。研究发现高表达于急性单核细胞白血病细胞的新抗原急性单核细胞白血病相关抗原-34(monocytic leukemia associated antigen-34,MLAA-34)具有抗白血病细胞凋亡作用,且MLAA-34多肽可诱导特异性CTL杀伤活性,具有较强的免疫原性,MLAA-34可作为急性单核细胞白血病免疫治疗新的理想靶抗原。总之,新近进展有价值的免疫治疗白血病相关抗原的鉴定有可能根除化疗后白血病微小残留病变,有望降低AML复发,延长AML患者生存。
Relapse after chemotherapy is inevitable in the majority of patients with acute myeloid leukemia（AML）.Allogeneic hemopoeitic stem cell transplantation is the most effective treatment of AML.Following transplant,recipient AML cells are eradicated by donor immune cells through the graft-versus-leukemia（GVL）effect which is effective for the prevention of relapse.The new era emerges as＂everyone has a donor for hematopoietic stem cell transplantation＂due to progress in transplant technology and haploid transplantation model.Targeted therapies,such as genetically engineered T cells（chimeric antigen receptor T cells）,monoclonal antibodies,and bispecific T-cell engagers,can specifically kill leukemia cells that express particular antigens,but do not damage normal cells,which will be new immunotherapeutic strategies for AML.It has been found that monocytic leukemia associated antigen-34（MLAA-34）is upregulated in acute monocytic leukemia cells and is a novel anti-apoptotic factor related closely to acute monocytic leukemia.MLAA-34 peptide can induce specific CTL killing activity and has a strong immunogenicity.MLAA-34 is a new promising new target antigen for therapeutic applications in AML.In short,recent advances in immunology and identification of promising leukemia-associated antigens open the possibilities for eradicating minimal residual diseases by antigen-specific immunotherapy after chemotherapy.Such progress will establish immunotherapy as an important armament to combat AML relapse and improve overall survival of AML patients.
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2015年第5期573-579,共7页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
陕西省科技统筹创新工程计划资助项目(No.2014KTCL03-01
2012KTCL03-11)~~
