Targeting the Immune Checkpoint in Cancer: Is This a Viable Treatment
Option for AML? by Steven J Coles in Open Access Journal of Oncology
and Medicine (OAJOM) - Lupine Publishers
The immune suppressive mechanisms
displayed by malignant cells are considered a central process in the
pathogenesis of cancer. Research in this area has gained significant
momentu mover the past 20 years, with several immune checkpoints
identified, including; CTLA-4, CD200/CD200R, Tim-3/Galectin-9 and
PD-L1/PD-1 (Figure 1). Whilst characterising the molecular basis of
leukaemia for risk stratification remains at the forefront of AML
research; this must now extend to understating how the seimmune
checkpoint path ways fit into the equation. A good example of why this
is important is to consider CD200expression level in AML, which is a
negative prognostic indicator [1]. CD200 is an immunosuppressive lig
and, that when engaged with its receptor CD200R, has the capacity to
attenuate T-cell and NK-cell anti-tumour activity in AML.
Interestingly, most cases of CBF AML express high levels of CD200, yet
CBF AML performs relatively well clinically. This paradox suggests
there is a complex interplay between AML molecular heterogeneity and
immune surveillance. Given the recent development and FDA approval of
several immune checkpoint therapies, a full understanding of these
processes and integration with standard molecular risk stratification is
warranted.
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