Abstract
The management of hematologic malignancies has traditionally relied on chemotherapy regimens, many of which are still in use today. However, with advancements in the knowledge of tumour pathophysiology, therapies are continually evolving. Monoclonal antibodies against specific targets on tumour cells are now widely used to treat hematologic malignancies, either in combination with chemotherapy or as single agents. Rituximab, a monoclonal antibody against the CD20 antigen, is a good example of successful monoclonal antibody therapy that has improved outcomes for patients with B cell non-Hodgkin lymphomas. Monoclonal antibodies are now being used against the immune checkpoints that function to inhibit T cell activation and subsequent tumour eradication by those cytotoxic T cells. Such therapies enhance T cell-mediated tumour eradication and are widely successful in treating patients with solid tumours such as malignant melanoma. Now, they are slowly finding their place in the management of hematologic neoplasms. Even though, currently, immune checkpoint inhibitors are used for relapsed or refractory hematologic neoplasms, trials are ongoing to evaluate their role in frontline treatment. Our review focuses on the current use of immunotherapies in various hematologic malignancies.
Highlights
Hematologic malignancies are complex set of disorders that are common in incidence
We focus on the current use of PD-1 inhibitors, ctla-4 inhibitors, and bite therapy for hematologic malignancies
Grade 3 or greater cytokine-release syndrome occurred in 4.9% of patients in the blinatumomab arm, but grade 3 or greater neurologic events were similar in the two arms (9.4% vs. 8.3%)
Summary
Hematologic malignancies are complex set of disorders that are common in incidence. Per Canadian cancer statistics, non-Hodgkin lymphoma (nhl) is the most common hematologic neoplasm, followed by leukemia, multiple myeloma (mm), and Hodgkin lymphoma (hl)[1]. Berger and colleagues[18] conducted one of the earlier trials evaluating the safety of pidilizumab in patients with advanced-stage hematologic malignancies after chemotherapy or sct, or both In their phase i study in 17 patients, which included individuals with nhl, hl, mm, chronic lymphocytic leukemia (cll), and acute myeloid leukemia (aml), a single dose of pidilizumab was delivered using an escalation schedule of 0.2–6 mg/kg, without any dose-limiting toxicities being observed (Table i). Lesokhin et al.[21] conducted one of the earlier trials evaluating the safety of nivolumab in patients with hematologic neoplasms Their phase i study included 81 patients with relapsed or refractory (r/r) nhl (including T cell nhl), classical Hodgkin lymphoma (chl), and mm after at least 1 prior line of therapy (Table ii).
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