Ter inleiding van het aanstaande jaarcongres (5-7 december) in Orlando (gevonden op hematology.org):
After years of continued advancements, allogeneic HSCT has become the most validated immunotherapy available today, used to treat and often cure many hematologic diseases. For example, in the case of myeloma, the combination of HSCT and advanced targeted therapies has dramatically improved long-term survival rates. Yet despite its value, serious side-effects associated with this treatment persist, leaving important research questions that must be answered to improve its safety and effectiveness.
4.3.1. New studies are required to help overcome current limitations of both cord blood and haplo-identical transplants, optimizing both donor selection and expansion of cord blood stem cells in order to advance the safety and success of this treatment.
4.3.2. [b]Advances that improve the safety of transplants by reducing relapse (improving graft-versus-leukemia (GVL) responses) and rates of complications (e.g., the incidence of graft-versus-host-disease (GVHD)) will allow for further expansion of this modality. Future research will illustrate whether the GVL effects of allogeneic HSCTs can be harnessed without further aggravating its toxicities, and new approaches to mitigate GVHD will improve patient outcomes after an allogeneic HSCT.
4.3.3. 4.3.3. Studies that can identify immunogenic minor antigens and novel molecular targets in various immune cells (e.g., T cells, Tregs, B cells, NK cell subsets, antigen-presenting cell (APC) subsets), map their interactions, and continue to analyze the immune repertoire will offer insights on how to mitigate GVHD while harnessing GVL responses.
4.3.4. Identification of patients who will respond to these therapies is needed, in addition to randomized clinical trials to evaluate the relative benefit of emerging immunotherapies against allogeneic HSCTs. Further, the cost, regulatory, and accessibility of these immune-based strategies must be improved to facilitate broad utilization by all patients who need them.