Understanding and enhancing the graft-versus-leukemia effect after hematopoietic stem cell transplantation

Immunotherapy advances for glioblastoma

Survival for patients with glioblastoma, the most common high-grade primary CNS tumor, remains poor despite multiple therapeutic interventions including intensifying cytotoxic therapy, targeting dysregulated cell signaling pathways, and blocking angiogenesis. Exciting, durable clinical benefits have recently been demonstrated for a number of other challenging cancers using a variety of immunotherapeutic approaches. Much modern research confirms that the CNS is immunoactive rather than immunoprivileged. Preliminary results of clinical studies demonstrate that varied vaccine strategies have achieved encouraging evidence of clinical benefit for glioblastoma patients, although multiple variables will likely require systematic investigation before optimal outcomes are realized. Initial preclinical studies have also revealed promising results with other immunotherapies including cell-based approaches and immune checkpoint blockade. Clinical studies to evaluate a wide array of immune therapies for malignant glioma patients are being rapidly developed. Important considerations going forward include optimizing response assessment and identifiying correlative biomarkers for predict therapeutic benefit. Finally, the potential of complementary combinatorial immunotherapeutic regimens is highly exciting and warrants expedited investigation.

Successful transplantation of ethnically mismatched cord blood in a boy with atypical chronic myeloid leukemia

In the present study, we describe unrelated umbilical cord blood transplantation (CBT) in a 7-year-old Taiwanese boy with atypical chronic myeloid leukemia (BCR-ABL 1 negative). Physical examination was notable for splenomegaly. Cytogenetic analyses from the bone marrow revealed a t(3;5)(p21;q31) translocation. The patient then underwent CBT from an HLA-mismatched (two loci by serotype, three loci by genotype) unrelated donor of Caucasian origin. Times to neutrophil and platelet engraftment were 21 and 62 days post-transplant, respectively. Acute graft-versus-host disease following transplantation was minimal. The patient remains in continuing hematological remission with full donor chimerism 28 months after transplantation.