Checkpoint inhibitors as potential therapeutics in acute myeloid leukemia

Despite recent progress in treatment methods, acute myeloid leukemia (AML) continues to pose significant clinical challenges and is associated with generally unfavorable prognoses. Patients considered fit for intensive therapy are usually treated with cytarabine-anthracycline-based induction chemotherapy. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is recommended for patients with adverse-risk AML and most patients with intermediaterisk AML. The standard therapy for patients who are deemed too poorly for intensive treatment is the combination of azacitidine and venetoclax. AML cells can escape the immune system through various mechanisms, including reduced expression of MHC complex molecules, ligand shedding, manipulation of chemical signaling, and enhanced inhibitory ligand expression. Increased expression of ligands for T-cell-regulation checkpoints is present in AML cells and correlates with worse outcomes. Therefore, this article reviews the current research progress in immune checkpoint inhibitors in AML.