Immune therapy of chronic myelogenous leukemia
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Goldman and Tura summarized these data and added their views. They considered data supporting an immune effect in CML to be convincing but wondered whether these effects translate to an autologous setting. They considered CML an excellent target for immune therapy in humans based on these data and on the presence of a canonical leukemia-specific antigen: P210bcr/ab. They concluded that progress in vaccine development is considerable and preliminary data from phase-1 and -2 trial are encouraging regarding feasibility and safety. However, use concurrent therapy(s) in these trials precludes any comment on efficacy. Several issues confound developing clinical trials design to test vaccines: (1) defining imatinib "resistance" is sometime difficult since many subjects respond to increasingly higher doses; (2) persons with biochemical resistance to imatinib are likely to receive the next generation of tyrosine kinase inhibitors rather than a vaccine; (3) quantitation of molecular responses is complex and there is substantial variability in technical details and definitions; (4) use of molecular remission as a surrogate for survival needs validation. And there are other concerns. Despite these issues, immune therapy of CML seems a promising area of basic and clinical science research. Results of appropriately designed phase-2 clinical trials in evaluable subjects is anxiously awaited. © 2004 Elsevier Ltd. All rights reserved.
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