Cellular Immunotherapy for Hematologic Malignancies: Beyond Bone Marrow Transplantation

Abstract

Immunotherapy has changed treatment practices for many hematologic malignancies. Even in the current era of targeted therapy, chemotherapy remains the backbone of treatment for many hematologic malignancies, especially in acute leukemias, where relapse remains the major cause of mortality. Application of novel immunotherapies in hematology attempts to harness the killing power of the immune system against leukemia and lymphoma. Cellular immunotherapy is evolving rapidly for high-risk hematologic disorders. Recent advances include chimeric antigen-receptor T cells, mesenchymal stromal/stem cells, dendritic cell tumor vaccines, cytokine-induced killer cells, and virus-specific T cells. The advantages of nontransplantation cellular immunotherapy include suitability for patients for whom transplantation has failed or is contraindicated, and a potentially less-toxic treatment alternative to transplantation for relapsed/refractory patients. This review examines those emerging cellular immunotherapies that are changing treatment paradigms for patients with hematologic malignancies.

Efficacy and Safety of Cellular Immunotherapy by Local Infusion for Liver Tumor: A Systematic Review and Meta-Analysis

“…Cell-based immunotherapy has a strong anti-tumor effect on cancer cells. One of the treatments with the most potential in recent years, it has an extraordinary effect on blood tumors ( 37 – 39 ), but challenges remain, i.e., liver cancer, one of the solid tumors ( 40 , 41 ). As most of the existing therapies use systemic infusion (i.e., intravenous infusion), these cells first reach the lung after entering the body, peak in 2–4 hours, and then are distributed to the liver, kidney, spleen, and other parts, tending to stabilize in 24 hours ( 42 ).…”

Shared inflammatory pathways and therapeutic strategies in COVID-19 and cancer immunotherapy

“…HLH can be a rare and fatal complication of HSCT, potentially related to GVHD, triggered by other mechanisms such as persistent Epstein-Barr virus reactivation. 45 CAR-T cells, engineered to recognize tumor antigens through a fusion protein comprised of an antibody-like moiety and T cell-signaling domains, 46 are frequently associated with CRS. In most clinical trials of CAR-T cell therapy for acute B-cell leukemia, the most common severe toxicity was CRS with an overall incidence of 70% and high-grade CRS reported in 15% of patients.…”

From CAR-T Cells to CAR-NK Cells: A Developing Immunotherapy Method for Hematological Malignancies

“…Hematological malignancies, which contribute to approximately 7% of all newly diagnosed cancers, represent a class of malignant clonal diseases originating in the hematopoietic system, mainly including leukemia, lymphoma and multiple myeloma (MM) (1,2). Allogeneic hematopoietic stem cell transplantation (allo-HSCT), considered "the ancestor of immunotherapy" in hematological malignancies, is often regarded as the sole curative approach for hematological malignancies (3,4). Although the overall survival of hematological malignancies has been improved due to improvements in allo-HSCT, the relapse of underlying malignancy remains a major cause of failure or death after transplantation (5).…”