Mohamed J Saadh, Waleed K Abdulsahib, Dilfuza Ashurova, Gaurav Sanghvi, Suhas Ballal, Rsk Sharma, Piyus Kumar Pathak, Shankhyan Aman, Abhinav Kumar, Fadhil Feez Sead, M V N L Chaitanya
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引用次数: 0
Abstract
Introduction: Acute Myeloid Leukemia is a heterogeneous hematological malignancy characterized by the uncontrolled proliferation of abnormal myeloid cells. Besides several other genetic abnormalities developed in AML, FLT3 mutations are significant due to their worse prognostic impacts and therapeutic resistance. As a result, these mutations enable AML cells to develop mechanisms for evading immune surveillance.
Areas covered: This review discusses the ways of immune escape of FLT3-mutated AML cells. A literature search was conducted on PubMed, Scopus, and Web of Science databases, covering articles published between 2010 and 2024 with related keywords. The discussion covers AML cells' downregulation of immune recognition markers, expression of immune checkpoint proteins, and establishment of an immunosuppressive tumor microenvironment. Specific attention is given to small extracellular vesicles and their participation in immune escape. The focus is on exosome-mediated pathways and possible combination therapies.
Expert opinion: FLT3 mutations in AML represent a formidable therapeutic challenge due to their crucial role in immune evasion. Exosomes are major players in these processes. Combination therapies targeting the exosome pathway could significantly improve these patients' immune recognition and overall outcomes. Understanding the underlying mechanisms, including targeted therapies, will be required to transcend existing therapeutic limitations and push newer strategies in treatment.
简介：急性髓系白血病是一种异质性血液系统恶性肿瘤，其特征是异常髓系细胞不受控制的增殖。除了AML中出现的其他几种遗传异常外，FLT3突变由于其较差的预后影响和治疗耐药性而具有重要意义。因此，这些突变使AML细胞能够发展出逃避免疫监视的机制。涉及领域：本文综述了flt3突变的AML细胞的免疫逃逸途径。对PubMed、Scopus和Web of Science数据库进行了文献检索，涵盖了2010年至2024年间发表的相关关键词的文章。讨论AML细胞对免疫识别标志物的下调、免疫检查点蛋白的表达以及免疫抑制肿瘤微环境的建立。特别关注小细胞外囊泡及其在免疫逃逸中的参与。重点是外泌体介导的途径和可能的联合治疗。专家意见：AML中的FLT3突变由于其在免疫逃避中的关键作用而代表了一个巨大的治疗挑战。外泌体是这些过程中的主要参与者。针对外泌体途径的联合治疗可以显著改善这些患者的免疫识别和总体预后。了解潜在的机制，包括靶向治疗，将需要超越现有的治疗限制，推动新的治疗策略。
期刊介绍：
Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches.
Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care.
Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections:
Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results
Article Highlights – an executive summary of the author’s most critical points.
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