الفهرس 
Hematological MalignanciesOnly 14 pages are availabe for public view
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Abstract
SUMMARY
The past two decades have seen substantial advances in
treatment of hematological malignant disorders. Present use of
intensified radiotherapy and chemotherapy protocols can lead to
first remission in most patients, and bone-marrow transplantation
or stem-cell transplantation are effective therapeutic options for
those who have disease recurrence. However, a substantial
number of patients will ultimately die of their disease. Therefore;
new non-cross resistant treatment strategies that might improve
outlook for patients are awaited.
The role of the immune system in the treatment of
hematologic malignancies has been well documented in a variety
of settings. The significant clinical effects observed by the
withdrawal of immunosuppression in patients with post-transplant
lymphoproliferative disorders, the increased anti-tumor effect of
allogeneic transplants over autologous, and the ability to reinduce
remissions with donor-lymphocyte infusions in a substantial
number of patients are all settings that point to the critical role of
the immune system in these diseases.
Emerging preclinical and clinical data suggest that
immune-cell mediators can recognize and kill malignant cells in
patients with hematological malignant disorders. The lower rates
of relapse in the setting of allogeneic transplantation compared
Summary
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with those in autologous bone marrow transplantation; the striking
clinical benefit of donor-lymphocyte infusions; and the clinical
effectiveness of antibody-based therapies for treatment of non-
Hodgkin lymphomas as well as the finding that human T-cells can
destroy chemotherapy-resistant cell lines from chronic myeloid
leukemia and multiple myeloma, have prompted development of
immunotherapeutic strategies against hematological cancers. Among
these approaches, active specific immunization or vaccination is
emerging as a valuable tool to polarize the adaptive immune system
against malignant cells.
The recent successes of antibody therapies in the treatment
of lymphomas and leukemias have highlighted the important antitumor
role of the immune system. It is now time to demonstrate
similar successes with cancer vaccines.
However, most cancer vaccines currently in development
are being created as therapeutic vaccines that work to stimulate
the immune response against tumors in patients who already have
cancer (rather than prevent the disease). Broadly speaking, the
therapeutic approaches can be divided into personalized vaccines
that make use of patients’ cells and off-the-shelf vaccines that do
not rely on material from the patient.
Studies are currently underway to investigate methods to
enhance monoclonal antibodies and vaccine strategies, including
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combinations with standard anticancer therapies or immune
modulating agents. Monoclonal antibodies and cancer vaccines
are usually well tolerated, with minimal toxicity compared with
chemotherapy. Therapeutic cancer vaccines can induce a focused
anti-tumor immune response by targeting specific tumor
associated antigens (TAAs) through T-cell stimulation.
Multiple recent trials are ongoing to prove the efficacy of
the monoclonal antibodies and vaccine therapy in variant
hematological malignancies in different ways and techniques