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Is There Still a Role for Autologous Stem Cell Transplantation for the Treatment of Acute Myeloid Leukemia?
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Immune Escape after Hematopoietic Stem Cell Transplantation (HSCT): From Mechanisms to Novel Therapies

1
Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
2
Hematology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(1), 69; https://doi.org/10.3390/cancers12010069
Received: 3 November 2019 / Revised: 21 December 2019 / Accepted: 24 December 2019 / Published: 25 December 2019
(This article belongs to the Special Issue Acute Myeloid Leukemia)
Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults. Recent advances in understanding its molecular basis have opened the way to new therapeutic strategies, including targeted therapies. However, despite an improvement in prognosis it has been documented in recent years (especially in younger patients) that allogenic hematopoietic stem cell transplantation (allo-HSCT) remains the only curative treatment in AML and the first therapeutic option for high-risk patients. After allo-HSCT, relapse is still a major complication, and is observed in about 50% of patients. Current evidence suggests that relapse is not due to clonal evolution, but instead to the ability of the AML cell population to escape immune control by a variety of mechanisms including the altered expression of HLA-molecules, production of anti-inflammatory cytokines, relevant metabolic changes and expression of immune checkpoint (ICP) inhibitors capable of “switching-off” the immune response against leukemic cells. Here, we review the main mechanisms of immune escape and identify potential strategies to overcome these mechanisms. View Full-Text
Keywords: acute myeloid leukemia; hematopoietic stem cell transplantation; relapse; donor lymphocyte infusion; hypomethylating agents; mechanisms of immune escape acute myeloid leukemia; hematopoietic stem cell transplantation; relapse; donor lymphocyte infusion; hypomethylating agents; mechanisms of immune escape
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Bernasconi, P.; Borsani, O. Immune Escape after Hematopoietic Stem Cell Transplantation (HSCT): From Mechanisms to Novel Therapies. Cancers 2020, 12, 69.

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