الفهرس 
IMMUNE SYSTEMOnly 14 pages are availabe for public view
 |  | from | 127 |  |  |
| | | from | 127 | | |
Abstract
The past two decades have seen substantial advances in treatment of hematological malignant disorders. Present use of intensified radiotherapy and chemotherapy protocols can lead to first remission in most patients, and bone-marrow transplantation or stem-cell transplantation are effective therapeutic options for those who have disease recurrence. However, a substantial number of patients will ultimately die of their disease. Therefore; new non-cross resistant treatment strategies that might improve outlook for patients are awaited.
The role of the immune system in the treatment of hematologic malignancies has been well documented in a variety of settings. The significant clinical effects observed by the withdrawal of immunosuppression in patients with post-transplant lymphoproliferative disorders, the increased anti-tumor effect of allogeneic transplants over autologous, and the ability to reinduce remissions with donor-lymphocyte infusions in a substantial number of patients are all settings that point to the critical role of the immune system in these diseases.
Emerging preclinical and clinical data suggest that immune-cell mediators can recognize and kill malignant cells in patients with hematological malignant disorders. The lower rates of relapse in the setting of allogeneic transplantation compared with those in autologous bone marrow transplantation; the striking clinical benefit of donor-lymphocyte infusions; and the clinical effectiveness of antibody-based therapies for treatment of non-Hodgkin lymphomas as well as the finding that human T-cells can destroy chemotherapy-resistant cell lines from chronic myeloid leukemia and multiple myeloma, have prompted development of immunotherapeutic strategies against hematological cancers. Among these approaches, active specific immunization or vaccination is emerging as a valuable tool to polarize the adaptive immune system against malignant cells.
The recent successes of antibody therapies in the treatment of lymphomas and leukemias have highlighted the important anti-tumor role of the immune system. It is now time to demonstrate similar successes with cancer vaccines.
However, most cancer vaccines currently in development are being created as therapeutic vaccines that work to stimulate the immune response against tumors inpatients who already have cancer (rather than prevent the disease). Broadly speaking, the therapeutic approaches can be divided into personalized vaccines that make use of patients’ cells and off-the-shelf vaccines that do not rely on material from the patient.
Advances in the understanding of the mechanisms of action of cellular anti-tumour immune responses have allowed the development of new generations of cancer vaccines.
Studies are currently underway to investigate methods to enhance vaccine strategies, including combinations with standard anticancer therapies or immune modulating agents. Cancer vaccines are usually well tolerated, with minimal toxicity compared with chemotherapy. Therapeutic cancer vaccines can induce a focused anti-tumor immune response by targeting specific tumor associated antigens (TAAs) through T-cell stimulation.
Multiple recent trials are ongoing to prove the efficacy of the vaccine therapy in variant hematological malignancies in different ways and techniques. Some of Phase II /III trials were completed with promising results and waiting for more confirmatory tests to be in use.