免疫逃逸在急性髓系白血病中的研究进展

Research Advance on the Immune Escape of Acute Myeloid Leukemia——Review

急性髓系白血病(acute myeloid leukemia,AML)是一种致死率很高的血液系统恶性肿瘤,患者5年生存率低于25%,老年患者低于10%。虽然规范化化疗或造血干细胞移植能明显提高急性髓系白血病的治疗效果,但大多数患者的复发仍是其治疗的一个难点。化疗加上免疫治疗被认为是最有希望的治疗手段,但免疫治疗过程中易发生的免疫逃逸,已成为影响AML治疗效果的重要因素。因此,了解AML免疫逃逸的机制、及时采取相应措施,对提高AML的治疗效果、降低AML复发具有重要意义。本文就导致免疫逃逸的重要细胞如髓源性抑制细胞(myeloid-derived suppressor cells,MDSC),自然杀伤细胞(natural killer cell,NK),以及细胞表面抑制性受体PD-1(programmed death 1)介导AML细胞产生免疫逃逸作用的最新研究进展作一综述,旨在为提高AML免疫治疗效果研究提供参考。

Acute myeloid leukemia(AML)is a kind of malignant hematological disease with high mortality.Patients 5-year survival rate is less than 25%and that of elderly patients is lower than 10%.Although the standardized chemotherapy or hematopoetic stem cell transplantation can significantly improve the therapeutic efficacy for AML,but disease recurrence is still a difficult problem in most patients.Chemotherapy combined with immunotherapy has been regarded as the most promising treatment for AML in recent years,but immunotherapy is prone to immune escape,which has become an important factor affecting the therapeutic efficacy.Therefore,understanding the mechanism of immune escape of AML and taking corresponding measures in time to improve the therapeutic effect and reduce the recurrence of AML are of great significance.In this review,the important cells that cause immune escape,such as myeloid-derived suppressor cells(MDSC),natural killer cells(NK),and cell surface inhibitory receptor PD-1(programmed death 1),which mediate immune escape of AML cells are summarized,so as to provide valuable reference for research to improve the effect of AML immunotherapy.