What are the new immunotherapy options for acute leukemia patients?

This review aimed to give an overview of the new types of immunotherapy that are available for adults with acute leukemia (AL).

This review concluded that immunotherapies will continue to be used and developed for cancer treatment. 

Acute myeloid leukemia (AML) occurs when abnormal myeloblasts are produced. Myeloblasts are a type of white blood cell that produce other cells. Abnormal myeloblasts cannot produce healthy cells. Lack of healthy cells can lead to a weak immune system, infection and bleeding.

Acute lymphoblastic leukemia (ALL) occurs when white blood cells called lymphocytes are overproduced and become abnormal. Lymphocytes function in fighting infections. The abnormal cells called lymphoblasts can kill normal cells and spread through the body.

A hematopoietic stem cell transplant (HSCT) is a common immunotherapy treatment for acute leukemia. It involves taking cells from a donor to transfer to a patient so they can replenish cells lost to cancer. A common problem with HSCT is graft versus host disease (GVHD). In GVHD the body begins to destroy its own cells. New immunotherapies are needed.

The immunotherapies discussed in this review are anti-body drug conjugates, bispecific T-cell engagers (BiTEs), chimeric antigen receptor T cells (CAR-Ts) and immune checkpoint inhibitors (ICPIs).

Antibody drug conjugates bind to antigens found on the surface of cancer cells. The drugs that are attached to the antibody are toxic to cancer cells and kill them. Examples of new antibody drug conjugates for AL are gemtuzumab ozogamicin (Mylotarg) and inotuzumab ozogamicin (Besponsa).

BiTEs connect cancer cells to cytotoxic T cells. Cytotoxic T cells work to kill the cancer cells. Blinatumomab (Blincyto) is an example of a BiTE that has been approved for ALL.

CART involves collecting and using patients own immune cells to treat their cancer. In this treatment, immune cells (the T-cells) are removed from the blood. The T-cells are then genetically modified in a laboratory to produce CAR. CAR is a protein that helps the T-cells recognize leukemia cells as something to attack. After the T-cells are modified, they are CAR-T cells. The CAR-T cells are reintroduced into the patient and will then attack AL cells. This treatment has been found to be effective in ALL.

ICPIs work to restore the function of cytotoxic T cells that are needed to kill cancer cells. During cancer their activity is limited. Examples include pembrolizumab (Keytruda), nivolumab (Opdivo), and ipilimumab (Yervoy).

This review concluded that immunotherapies will continue to be used and developed for use in cancer treatment. 

Consult your physician about the types of immunotherapy that are available to you.