TY - JOUR
T1 - NCI First International Workshop on the Biology, Prevention and Treatment of Relapse after Allogeneic Hematopoietic Cell Transplantation
T2 - Report from the Committee on Prevention of Relapse Following Allogeneic Cell Transplantation for Hematologic Malignancies
AU - Alyea, Edwin P.
AU - DeAngelo, Daniel J.
AU - Moldrem, Jeffrey
AU - Pagel, John M.
AU - Przepiorka, Donna
AU - Sadelin, Michel
AU - Young, James W.
AU - Giralt, Sergio
AU - Bishop, Michael
AU - Riddell, Stan
PY - 2010/8
Y1 - 2010/8
N2 - Prevention of relapse after allogeneic hematopoietic stem cell transplantation is the most likely approach to improve survival of patients treated for hematologic malignancies. Herein we review the limits of currently available transplant therapies and the innovative strategies being developed to overcome resistance to therapy or to fill therapeutic modalities not currently available. These novel strategies include nonimmunologic therapies, such as targeted preparative regimens and posttransplant drug therapy, as well as immunologic interventions, including graft engineering, donor lymphocyte infusions, T cell engineering, vaccination, and dendritic cell-based approaches. Several aspects of the biology of the malignant cells as well as the host have been identified that obviate success of even these newer strategies. To maximize the potential for success, we recommend pursuing research to develop additional targeted therapies to be used in the preparative regimen or as maintenance posttransplant, better characterize the T cell and dendritic cells subsets involved in graft-versus-host disease and the graft-versus-leukemia/tumor effect, identify strategies for timing immunologic or nonimmunologic therapies to eliminate the noncycling cancer stem cell, identify more targets for immunotherapies, develop new vaccines that will not be limited by HLA, and develop methods to identify populations at very high risk for relapse to accelerate clinical development and avoid toxicity in patients not at risk for relapse.
AB - Prevention of relapse after allogeneic hematopoietic stem cell transplantation is the most likely approach to improve survival of patients treated for hematologic malignancies. Herein we review the limits of currently available transplant therapies and the innovative strategies being developed to overcome resistance to therapy or to fill therapeutic modalities not currently available. These novel strategies include nonimmunologic therapies, such as targeted preparative regimens and posttransplant drug therapy, as well as immunologic interventions, including graft engineering, donor lymphocyte infusions, T cell engineering, vaccination, and dendritic cell-based approaches. Several aspects of the biology of the malignant cells as well as the host have been identified that obviate success of even these newer strategies. To maximize the potential for success, we recommend pursuing research to develop additional targeted therapies to be used in the preparative regimen or as maintenance posttransplant, better characterize the T cell and dendritic cells subsets involved in graft-versus-host disease and the graft-versus-leukemia/tumor effect, identify strategies for timing immunologic or nonimmunologic therapies to eliminate the noncycling cancer stem cell, identify more targets for immunotherapies, develop new vaccines that will not be limited by HLA, and develop methods to identify populations at very high risk for relapse to accelerate clinical development and avoid toxicity in patients not at risk for relapse.
KW - Acute graft-versus-host disease
KW - Allogeneic hematopoietic cell transplantation
KW - Immunotherapy
KW - Relapse prevention
KW - Resistant leukemia
UR - http://www.scopus.com/inward/record.url?scp=77954288771&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954288771&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2010.05.005
DO - 10.1016/j.bbmt.2010.05.005
M3 - Review article
C2 - 20580849
AN - SCOPUS:77954288771
SN - 1083-8791
VL - 16
SP - 1037
EP - 1069
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 8
ER -