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
03/14/2019Pubmed ID
30863527Pubmed Central ID
PMC6410023DOI
10.2217/ijh-2018-0009Abstract
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 MJAuthors
Larisa Broglie MD, MS Associate Professor in the Pediatrics department at Medical College of WisconsinMichael James Burke MD Professor in the Pediatrics department at Medical College of Wisconsin