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Current Hematologic Malignancy Reports
Published in: Current Hematologic Malignancy Reports 1/2017

01-02-2017 | Stem Cell Transplantation (R Maziarz, Section Editor)

Immune Checkpoint Blockade and Hematopoietic Stem Cell Transplant

Authors: Reid W. Merryman, Philippe Armand

Published in: Current Hematologic Malignancy Reports | Issue 1/2017

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Abstract

Allogeneic hematopoietic stem cell transplant (HSCT) relies primarily upon graft-versus-tumor activity for cancer eradication. Relapse remains the principal cause of treatment failure after HSCT, implying frequent immune escape, which in at least some cases, appears to be mediated by increased expression of inhibitory immune checkpoints. In an attempt to restore anti-tumor immunity, checkpoint blockade therapy (CBT) targeting PD-1 and CLTA-4 has been used in conjunction with both allogeneic and autologous HSCT. Clinical experience in this setting is limited to several small clinical trials and case series, but together they suggest that treatment with CBT can effectively amplify anti-tumor immune responses. However, intrinsic to its mechanism is also the risk that CBT in the HSCT setting may also cause significant immune toxicity. Fatal immune-related adverse events and graft-versus-host disease have been observed, but in most cases, immune side effects appear to be reversible with steroids and CBT discontinuation. As clinical investigation continues, improved understanding of immune checkpoint biology will be critical to optimize safe and efficacious treatment strategies.
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Metadata
Title
Immune Checkpoint Blockade and Hematopoietic Stem Cell Transplant
Authors
Reid W. Merryman
Philippe Armand
Publication date
01-02-2017
Publisher
Springer US
Published in
Current Hematologic Malignancy Reports / Issue 1/2017
Print ISSN: 1558-8211
Electronic ISSN: 1558-822X
DOI
https://doi.org/10.1007/s11899-017-0362-5

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