Adoptive immunotherapy to treat leukemic relapse following allogeneic hematopoietic stem cell transplantation

Acute leukemia patients who relapse after haematopoetic stem cell transplantation (HSCT) have poor prognosis with few therapeutic options. An immunotherapeutic approach that specifically targets the leukemia to treat and prevent these relapses could improve survival rates for these patients. Recently a number of potential antigenic targets for leukemia have been described. These include over-expressed normal antigens such as survivin, leukemia-specific targets resulting from translocations and mutations and hematopoietic-restricted minor histocompatibility antigens such as HA-1 and HA-2. Considerable experimental data indicates that cytotoxic T cells targeting these antigens can be generated in vitro. Further improvements in the efficacy of antigen presentation and T cell activation and expansion will facilitate the clinical application of these T cells as a therapeutic strategy for patients who are likely to relapse after HSCT.