Relapse Prevention in Acute Myeloid Leukemia: The Role of Immunotherapy with Histamine Dihydrochloride and Low-Dose Interleukin-2

• Published in: Cancers Vol. 16; no. 10; p. 1824
• Main Authors: Montesinos, Pau, Buccisano, Francesco, Cluzeau, Thomas, Vennström, Lovisa, Heuser, Michael
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.05.2024
• Subjects: Acute myeloid leukemia; Allografts; Cancer; Chemotherapy; Chromosomes; Cytokines; Cytotoxicity; Diseases; Dosage and administration; Health aspects; Histamine; Immunomodulation; Immunotherapy; Interleukin 2; Interleukins; Karyotypes; Killer cells; Leukemia; Lymphocytes; maintenance; Morbidity; Mortality; Natural killer cells; Oncology, Experimental; Patients; Pharmaceutical industry; Relapse; Remission; Remission (Medicine); Respiratory agents; Stem cell transplantation; Stem cells; Switzerland; Transplantation; Transplants & implants; United States; United States; Switzerland; interleukin-2; histamine; acute myeloid leukemia; maintenance; immunotherapy
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers16101824

The treatment and management of acute myeloid leukemia (AML) has improved in recent decennia by targeted therapy for subgroups of patients, expanded indications for allogeneic stem cell transplantation (allo-SCT) and surveillance of residual or arising leukemia. However, hematological relapse among patients who have attained complete remission (CR) after the initial courses of chemotherapy remains a significant cause of morbidity and mortality. Here, we review an immunotherapeutic option using histamine dihydrochloride and low-dose interleukin-2 (HDC/LD-IL-2) for remission maintenance in AML. The treatment is approved in Europe in the post-consolidation phase to avoid relapse among patients in CR who are not candidates for upfront allo-SCT. We present aspects of the purported anti-leukemic mechanism of this regimen, including translation of preclinical results into the clinical setting, along with relapse prevention in subgroups of patients. We consider that HDC/LD-IL-2 is a conceivable option for younger adults, in particular patients with AML of normal karyotype and those with favorable responses to the initial chemotherapy. HDC/LD-IL-2 may form an emerging landscape of remission maintenance in AML.