[HTML][HTML] NCI First International Workshop on The Biology, Prevention and Treatment of Relapse after Allogeneic Hematopoietic Cell Transplantation: report from the …

EP Alyea, DJ DeAngelo, J Moldrem, JM Pagel… - Biology of Blood and …, 2010 - Elsevier
EP Alyea, DJ DeAngelo, J Moldrem, JM Pagel, D Przepiorka, M Sadelin, JW Young, S Giralt
Biology of Blood and Marrow Transplantation, 2010Elsevier
Prevention of relapse after allogeneic hematopoietic stem cell transplantation (HSCT) 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 …
Prevention of relapse after allogeneic hematopoietic stem cell transplantation (HSCT) 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 (DLI), 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 (GVHD) and the graft-versus-leukemia/tumor (GVL/GVT) 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 population at very high risk for relapse to accelerate clinical development and avoid toxicity in patients not at risk for relapse.
Elsevier