Immunotherapy in the Management of Hematologic Malignancy

Dear Colleagues,

Hematologic malignancies are heterogeneous groups of diseases that include Hodgkin and non-Hodgkin lymphoma, multiple myeloma and plasma cell dyscrasias, acute and chronic leukemia, and myelodysplasia. Each year more than a million people die from hematologic malignancies around the world due to lack of effective therapies. While conventional chemotherapy and high-dose chemotherapy followed by autologous or allogeneic hematopoietic stem cell transplantation have shown significant clinical activity in the management of patients with hematological malignancies, chemotherapy-induced toxicities, including cytopenia and opportunistic infections, as well as transplant-specific toxicities such as donor T-cell-mediated graft-vs-host disease (GvHD), represent life-threatening complications that limit the application of these approaches to younger and healthier patients. New treatment strategies based upon immunotherapy are now showing promise in treating patients whose disease has relapsed after conventional chemotherapy.  The failure of innate immunity (NK, macrophages, etc) and adaptive immunity (CD4+ and CD8+ T-cells) is believed to be responsible for the development of clinically detectable hematological malignancies. Therefore, novel treatment strategies that stimulate the immune system to attack newly generated cancer cells are the primary basis of novel immunotherapy treatments.

Several types of immunotherapy that have been found to be clinically useful include: (1) cytokines therapy (IL-2, interferons, GMCSF, IL-12, etc.); (2) therapies based on humanized monoclonal antibodies (Afutuzumab targeting CD20 expressing lymphoma, Apolizumab targeting HLA-DR expressing hematological cancer cells, etc); (3) monoclonal antibodies that prevent T-cell tolerance (PD-1, PD-L1, CTLA-4, etc.); and (4) adoptive T-cell therapy engineered to express chimeric antigen receptors (CARs) targeting selective tumors.

Dr. Mohammad S. Hossain
Guest Editor

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• allo/auto HSCT
• GvHD
• immunotherapy
• viral infection
• hematologic malignancy