2022
DOI: 10.3390/biomedicines10061410
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Targeting the Tumor Microenvironment in Acute Myeloid Leukemia: The Future of Immunotherapy and Natural Products

Abstract: The tumor microenvironment (TME) plays an essential role in the development, proliferation, and survival of leukemic blasts in acute myeloid leukemia (AML). Within the bone marrow and peripheral blood, various phenotypically and functionally altered cells in the TME provide critical signals to suppress the anti-tumor immune response, allowing tumor cells to evade elimination. Thus, unraveling the complex interplay between AML and its microenvironment may have important clinical implications and are essential t… Show more

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Cited by 10 publications
(9 citation statements)
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“…With the development of oncology, immunology, cell biology, molecular biology, and other related disciplines in recent years [52], tumor immunotherapy has received increasing attention [53]. However, due to the complex process of tumor immunity, the combined effect of multiple mechanisms affects the e cacy of immune checkpoint inhibitors (ICIs) [54].…”
Section: Discussionmentioning
confidence: 99%
“…With the development of oncology, immunology, cell biology, molecular biology, and other related disciplines in recent years [52], tumor immunotherapy has received increasing attention [53]. However, due to the complex process of tumor immunity, the combined effect of multiple mechanisms affects the e cacy of immune checkpoint inhibitors (ICIs) [54].…”
Section: Discussionmentioning
confidence: 99%
“…Despite the lack of a consensus, in patients who are not considered candidates for intensive therapy, following regimens are often used in the context of clinical trials: Azacitidine or decitabine + venetoclax combination, low dose cytarabine + venetoclax combination, azacitidine + ivosidenib combination (AML with IDH1 mutation), ivosidenib monotherapy for very frail patients (AML with IDH1 mutation) or best supportive care including hydroxyurea for patients who cannot tolerate or refuse any anti-leukemic therapy (20). To be considered in remission, bone marrow biopsy should show normocellular bone marrow while blasts should not exceed 5%; yet many patients develop relapsed and refractory diseases despite therapeutic options (22). Stem cell transplantations are reported to decrease the risk of leukemia relapse more than the standard chemotherapeutic approaches, yet they are also likely to lead to severe complications (23).…”
Section: Current Treatment Strategies In Acute Myeloid Leukemiamentioning
confidence: 99%
“…Besides the abovementioned therapeutic interventions, other immunotherapeutic strategies in AML include immune checkpoint blockade, bispecific T cell engagers (BiTE), chimeric antigen receptor T cells (CAR-T) and tissue infiltrating lymphocytes (TIL) are under investigation (19,22). As extensively described in the literature, the expression of inhibitory checkpoint proteins on AML blasts has been recognized as an important immune escape mechanism (29).…”
Section: Current Treatment Strategies In Acute Myeloid Leukemiamentioning
confidence: 99%
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“…To date, major efforts have been made to understand the immune landscape within the context of the bone marrow microenvironment in AML ( 15 , 16 ). However, the role of the thymic microenvironment in propagating AML progression is largely underrecognized, but a potentially important aspect of AML biology.…”
Section: Introductionmentioning
confidence: 99%