The Immune Microenvironment in Acute Myeloid Leukemia: Mechanisms of Immune Evasion and Emerging Therapeutic Strategies

Acute Myeloid Leukemia (AML), a diverse type of blood cancer, is characterized by the unchecked multiplication of myeloid precursor cells within a disrupted bone marrow microenvironment (BMM).Leukemic blasts alter the BMM to create a leukemia niche, promoting immunological evasion and disease development.High relapse rates highlight the need for novel therapeutic approaches, even if chemotherapy is still the cornerstone of treatment.AML cells use many strategies to avoid immune identification, such as suppressing anti-leukemic immune responses and upregulating immune checkpoints.Immunotherapies like checkpoint inhibitors that target these pathways have shown encouraging promise.The intricate relationships between AML and the immunological milieu are examined in this review, with a focus on immune evasion, treatment resistance, and innovative immunotherapeutic strategies to improve anti-leukemic immunity.