28.02.2013 Views

autologous blood and marrow transplantation - Blog Science ...

autologous blood and marrow transplantation - Blog Science ...

autologous blood and marrow transplantation - Blog Science ...

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

648 Chapter 13: Immunotherapy<br />

are often available. In addition, in many cases, endogenous tumor antigens, with<br />

unique specificity resulting from mutated genes or chimeric proteins arising from<br />

chromosomal translocations, would be a prerequisite for the tumor cell being<br />

recognized by T lymphocytes as foreign. Normal tissues or cells which did not<br />

express these abnormal antigens would not be expected to be recognized as targets<br />

just because they expressed a costimulatory receptor. As specific immunostimulatory<br />

tumor antigens are identified, the possibility of developing acellular, tumor<br />

vaccines by combining antigen preparations with targeted, immunostimulatory<br />

signals may prove possible.<br />

Another critical aspect to the development of tumor vaccine approaches will be<br />

to determine when the most optimal time for vaccination should be in clinical<br />

settings. Clearly, the ability to mount a sufficient immune response is critical. This<br />

ability may be affected by the amount of tumor burden as well as the immunosuppressive<br />

effects of chemotherapeutic regimens, especially those involving conventional<br />

stem cell <strong>transplantation</strong>.<br />

Alternative approaches to the circumvention of tumor cell resistance will likely<br />

include the enhancement of antitumor immunity through a variety of means as well<br />

as the exploitation of growth <strong>and</strong> apoptotic pathways. Although these latter<br />

approaches are in many cases still in the realm of the tissue culture dish or small<br />

animal models, they also represent part of the hope for more targeted <strong>and</strong> less toxic<br />

therapies for patients with cancer.<br />

ACKNOWLEDGMENTS<br />

This work was supported in part by the Leukemia Society of America.<br />

REFERENCES<br />

1. Arceci RJ: Tumor cell survival <strong>and</strong> resistance to therapy. Curr Opin Hematol 3:279-287,<br />

1996.<br />

2. Arceci RJ: Clinical significance of P-glycoprotein in multidrug resistance malignancies.<br />

Blood 81:2215-2222, 1993.<br />

3. Borst P: Genetic mechanisms of drug resistance. A review. Acta Oncol 30:87-105,1991.<br />

4. Nooter K, Herweijer H: Multidrug resistance (mdr) genes in human cancer. Br J Cancer<br />

63:663-669, 1991.<br />

5. Weinstein HJ, Griffin JD: Acute myelogenous leukemia. In: H<strong>and</strong>in RI, Lux SE, Stossel<br />

TP (eds) Blood: Principle <strong>and</strong> Practice of Hematology. Philadelphia: Lippincott, 1995,<br />

p. 543-574.<br />

6. Goldstein LJ: Clinical reversal of drug resistance. Curr Prob Cancer 19:65-124, 1995.<br />

7. Ford JM, Yang JM, Hait WN: P-glycoprotein-mediated multidrug resistance:<br />

Experimental <strong>and</strong> clinical strategies for its reversal. Cancer Treatment Res 87:3-38,<br />

1996.

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!