Restoration of the immune function as a complementary strategy to treat Chronic Lymphocytic Leukemia effectively

Chronic Lymphocytic Leukemia (CLL) is a hematological malignancy characterized by uncontrolled proliferation of B-cells and severe immune dysfunction. Chemo(immuno)therapies (CIT) have traditionally aimed to reduce tumor burden without fully understanding their effects on the immune system. As a con...

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Detalles Bibliográficos
Autores: Moreno, Carol|||0000-0003-3275-0271, Muñoz Calleja, Cecilia|||0000-0003-0706-3728, Terol, Maria Jose|||0000-0002-9467-932X, Hernández Rivas, José Ángel|||0000-0003-4550-757X, Villanueva, Miguel
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:264730
Acceso en línea:https://ddd.uab.cat/record/264730
https://dx.doi.org/urn:doi:10.1186/s13046-021-02115-1
Access Level:acceso abierto
Palabra clave:Immune function
Ibrutinib
CLL
Chronic Lymphocytic Leukemia
Descripción
Sumario:Chronic Lymphocytic Leukemia (CLL) is a hematological malignancy characterized by uncontrolled proliferation of B-cells and severe immune dysfunction. Chemo(immuno)therapies (CIT) have traditionally aimed to reduce tumor burden without fully understanding their effects on the immune system. As a consequence, CIT are usually associated with higher risk of infections, secondary neoplasms and autoimmune disorders. A better understanding of the biology of the disease has led to the development of therapeutic strategies which not only act against malignant B-cells but also reactivate and enhance the patient's own anti-tumor immune response. Here, we review the current understanding of the underlying interplay between the malignant cells and non-malignant immune cells that may promote tumor survival and proliferation. In addition, we review the available evidence on how different treatment options for CLL including CIT regimens, small molecular inhibitors (i.e, BTK inhibitors, PI3K inhibitors, BCL-2 inhibitors) and T-cell therapies, affect the immune system and their clinical consequences. Finally, we propose that a dual therapeutic approach, acting directly against malignant B-cells and restoring the immune function is clinically relevant and should be considered when developing future strategies to treat patients with CLL.