Immunotherapy with histamine dihydrochloride for the prevention of relapse in acute myeloid leukemia

Expert Rev Hematol. 2010 Aug;3(4):381-91. doi: 10.1586/ehm.10.30.

Abstract

Most patients with acute myeloid leukemia (AML) achieve complete remission (CR) after induction chemotherapy. Despite ensuing courses of consolidation chemotherapy, a large fraction of patients will experience relapses with poor prospects of long-term survival. Histamine dihydrochloride (HDC) in combination with the T-cell-derived cytokine IL-2 was recently approved within the EU as a remission maintenance immunotherapy in AML. HDC reduces myeloid cell-derived suppression of anti-leukemic lymphocytes, and aims to unravel a therapeutic benefit of IL-2 in AML by improving natural killer and T-cell activation. A randomized Phase III trial with 320 AML patients in CR demonstrated a significant reduction of relapse risk after immunotherapy with HDC plus low-dose IL-2 in the post-consolidation phase. HDC is the first approved therapeutic to target the state of immunosuppression in AML; further development in this area may comprise supplementary or alternative counter-suppressive agents with the aim to improve the efficacy of cancer immunotherapy.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / immunology
  • Antineoplastic Agents / therapeutic use*
  • Histamine / adverse effects
  • Histamine / immunology
  • Histamine / therapeutic use*
  • Humans
  • Immunotherapy*
  • Interleukin-2 / adverse effects
  • Interleukin-2 / immunology
  • Interleukin-2 / therapeutic use
  • Leukemia, Myeloid, Acute / drug therapy*
  • Molecular Targeted Therapy
  • Secondary Prevention

Substances

  • Antineoplastic Agents
  • Interleukin-2
  • Histamine