Promise of Immunotherapy of the Chronic Myeloid Leukaemia
Možnosti imunoterapie chronické myeloidní leukémie
Vzhledem k přítomnosti jedinečných antigenů v nádorových buňkách představuje chronická myeloidní leukémie atraktivní cíl pro imunoterapii. Pokroky v oblastech genové terapie, nádorové imunologie a vakcinologie nabízejí celé spektrum preparátů, které by mohly být využity pro tento účel. Dosud omezené zkušenosti získané na pacientech s chronickou myeloidní leukémií demonstrují, že je možné vyvolat specifické imunitní reakce pomocí syntetických peptidových vakcín. Jejich klinická účinnost je však prozatím malá. Probíhající studie na myších modelech by měly ukázat, jak vyvolat účinnou imunitu proti buňkám transformovaným fúzním genem bcr-abl. Autor diskutuje výhody ale i omezení zvířecích modelů pro vývoj prostředků imunoterapie chronické myeloidní leukémie. Zabývá se i možností, že vakcíny založené na imunogenech odvozených od proteinu bcr-abl a prokazatelně účinné v myších modelech nebudou mít žádoucí léčebný efekt u pacientů s chronickou myeloidní leukémií, a navrhuje, jak se s možnými problémy vyrovnat.
Klíčová slova:
chronická myeloidní leukémie, imunologie, vakcíny.
Authors:
V. Vonka
Authors‘ workplace:
Ústav hematologie a krevní transfuze, Praha
Published in:
Čas. Lék. čes. 2005; 144: 172-176
Category:
Review Article
Overview
Because of the presence of unique antigens, chronic myeloid leukaemia (CML) represents an appealing target for immunotherapy. The progress achieved in the fields of gene therapy, tumour immunology and vaccinology offers a wide spectrum of methods that could be utilized for the development of therapeutic vaccines against CML. Experience obtained in several clinical studies with peptide-based vaccines have made it clear that it is possible to induce specific immune reactivity; however, its clinical efficacy has been low if any. Studies in mouse systems, which are under way, should be helpful in defining the optimal strategy for immunizing human subjects against bcr-abl positive cells. The author adduces some advantages, but also the limitations, of animal models for this purpose. He also comments on the possibility that the bcr-abl-based therapeutic vaccines might be found ineffective and proposes procedures how to deal with the problem.
Key words:
chronic myelogenous leukaemia, immunology, vaccines.
Labels
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