1Pharmacy School, University of Maryland, Baltimore, US
2Collage of Pharmacy, Department of Clinical Pharmacy, National University of Science and Technology, DhiQar, Iraq
3Department of Pharmacy, Al-Manara College for Medical Sciences, Amarah, Iraq
4Department of Pharmacology, College of Medicine, University of Baghdad, Baghdad, Iraq
5Dr. Hany Akeel Institute, Iraqi Medical Research Center, Baghdad, Iraq
6Department of Pharmacy, Kut University College, Alkut, Wasit, 52001, Iraq
8Department of Pharmacy, Al-Turath University, Baghdad, Iraq
Acute myeloid leukemia (AML) is a heterogeneous malignancy principally affecting the elderly population. Despite advances regarding molecular dissection of the disease, prognosis remains poor, with an overall survival of less than 30%. Current treatment for patients with newly diagnosed AML usually includes intensive chemotherapy treatment or allogeneic hematopoietic stem cell transplantation.
Our review aims to provide an overview of T cell responses in AML, including the role of T cells in immune surveillance, tumour immunosuppression, and emerging immunotherapeutic approaches targeting T cell responses in AML.
A comprehensive review of the literature was conducted to identify studies investigating T cell responses in AML. Key findings from preclinical models, clinical trials, and translational research were synthesized to elucidate the mechanisms underlying T cell-mediated immunity in AML and its implications for therapeutic intervention.
T cells play a critical role in immune surveillance against AML cells through the recognition and elimination of leukaemic antigens presented on the surface of malignant cells. However, AML cells employ various mechanisms to evade immune detection and suppress T cell-mediated responses, including downregulation of antigen presentation, upregulation of immune checkpoint molecules, and recruitment of immunosuppressive cell populations such as regulatory T cells and myeloid-derived suppressor cells. Despite these challenges, emerging immunotherapeutic strategies aimed at enhancing T cell responses in AML, such as chimeric antigen receptor (CAR) T cell therapy, bispecific T cell engagers (BiTEs), and immune checkpoint blockade, hold promise for improving outcomes in AML patients.
Currently, standard treatment consists of chemotherapy but only a subset of AML patients responds, and those achieving complete remission often relapse. There is a great need for new, more effective therapies, and immunotherapy is one of the most promising alternatives. T cells are major players for an effective immune response to cancer, but their functionality is often compromised by various, including cancer evasion strategies, thus enhancing the need for understanding the T cell compartment in this disease.
T cells, AML cells, Chimeric antigen receptor, Immunotherapeutic
