Cellular immunotherapy for hematological malignancy: recent progress and future perspectives

Abstract

Advancements in the field of cellular immunotherapy have accelerated in recent years and have changed the treatment landscape for avariety of hematologic malignancies. Cellular immunotherapy strategies exploit the patient’s immune system to kill cancer cells. Thesuccessful use of CD19 chimeric antigen receptor (CAR) T-cells in treating B-cell malignancies is the paradigm of this revolution,and numerous ongoing studies are investigating and extending this approach to other malignancies. However, resistance to CAR-Tcelltherapy and non-durable efficacy have prevented CAR-T-cells from becoming the ultimate therapy. Because natural killer (NK)cells play an essential role in antitumor immunity, adoptively transferred allogeneic NK and CAR-modified NK cell therapy hasbeen attempted in certain disease subgroups. Allogenic hematopoietic stem cell transplantation (allo-HSCT) is the oldest form ofcellular immunotherapy and the only curative option for hematologic malignancies. Historically, the breadth of application of allo-HSCT has been limited by a lack of identical sibling donors (ISDs). However, great strides have recently been made in the successof haploidentical allografts worldwide, which enable everyone to have a donor. Haploidentical donors can achieve comparableoutcomes to those of ISDs and even better outcomes in certain circumstances because of a stronger graft vs. tumor effect. Currently,novel strategies such as CAR-T or NK-based immunotherapy can be applied as a complement to allo-HSCT for curative effects,particularly in refractory cases. Here, we introduce the developments in cellular immunotherapy in hematology.