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Checkpoint inhibition of PD-L1 and CTLA-4 in a child with refractory acute leukemia. Int J Hematol Oncol 2019 Feb;8(1):IJH10

Date

03/14/2019

Pubmed ID

30863527

Pubmed Central ID

PMC6410023

DOI

10.2217/ijh-2018-0009

Abstract

Children with multiple relapsed or refractory leukemia have dismal survival. Research has identified engagement of immune checkpoint receptors (e.g., PD-1, PD-L1 and CTLA-4) as a mechanism for treatment resistance. For adult cancer, inhibitors of PD-1 (nivolumab) and CTLA-4 (ipilimumab) have shown promise with response rates ranging from 7 to 40%. In vitro studies using acute myeloid leukemia cell lines have shown that acute myeloid leukemia blasts may similarly utilize the PD-1/PD-L1 axis to evade an anticancer immune response. We report the first case of a pediatric patient with multiple relapsed/refractory leukemia treated with nivolumab, ipilimumab and 5-azacytidine who tolerated therapy with brief improvement of symptoms.

Author List

Broglie L, Gershan J, Burke MJ

Authors

Larisa Broglie MD, MS Associate Professor in the Pediatrics department at Medical College of Wisconsin
Michael James Burke MD Professor in the Pediatrics department at Medical College of Wisconsin