The Immunological Dilemma: Cellular Innate and Adaptive Immune Response

It is generally accepted that acute myelogenous leukemia (AML) patients are immunocompromized. On the other hand, antileukemic immune reactivity is important for the improved survival of AML patients treated with allogeneic stem cell transplantation and antileukemic immunotherapy is also considered for patients treated with conventional chemotherapy. In this article, we review the available studies of disease- and therapy- induced immune dysfunctions in AML patients, including the function of the cellular innate and adaptive immune system of AML patients (i) with newly diagnosed disease before treatment, (ii) immunological functions of AML patients with severe therapy induced cytopenia before hematopoietic reconstitution; and (iii) the immune reconstitution following the initial period of hematopoietic reconstitution after autologous and allogeneic stem cell transplantation. A more detailed knowledge about the immune systems of these patients is essential for an optimal design of future clinical immunotherapy studies in AML.