• An overview of the Advancements in Acute Myeloid Leukaemia (AML) treatments with the potential of CAR-NK cells immunotherapy
  • Pargol Yakhchi,1,*
    1. Department of Basic Sciences, Faculty of Microbiology, Borujerd Branch, Islamic Azad University, Borujerd, Iran


  • Introduction: Introduction: AML is the short form of Acute Myeloid Leukaemia cancer , which is recognised as a cancer defined by the penetration of the bone marrow and blood in the human body. These side effects often lead to hematopoietic insufficiency, which can present as granulocytopenia, thrombocytopenia, or even anaemia. Similar to other cancers, AML results from genetic modifications (4)(1). In addition, the rate for AML is eastimatly 32%, and would be up to 50% for younger patients and less than 10% for those over 60 years old. (1)(2)(3) Moreover, fifty years ago, AML was considered incurable; however, current treatments such as CAR-NK cell therapy have improved noticeable outcomes, with a wide range of cure rates of 35 to 40% among adult patients 60 or younger, in addition a cure rate of 5 to 15% for those older than 60 (2)(4)(6) comparing to the new treatments the old treatment for AML cancer are involves several stages. Originally, remission was induced by the exploitation of traditional therapies such as daunorubicin and cytarabine. AML Therapy might involve allogeneic or autologous bone marrow transplantation for treatment, also with high-dose chemotherapy, and finally, stem-cell transplantation.(1) also to tackle this issue the standard components of frontline treatment for AML. Which are Including netoclax, FLT3 inhibitors (such as gilteritinib, quizartinib, and midostaurin), IDH inhibitors (consisting of ivosidenib, enasidenib, and olutasidenib), studies show that for younger and fitter patients who suffer from AML, the conventional treatment often specified as the 7 + 3 process (or 3 + 7 or 3 + 10) assumes cytarabine for 7 to 10 days alongside daunorubicin for 3 days. (5) On the other hand identify of the AML in patient is important .first researchers resinized the AML then take step for new treatments like CAR-NK cells therapy The very fundamental role key method for diagnosing Acute Myeloid Leukemia (AML) focused on the morphological identification of leukemic myeloblasts in stained samples of peripheral blood and bone marrow using Wright–Giemsa staining.(1) Also it is worth noting that the symptoms of the AML would be clinical symptoms mentioned as fatigue, bleeding, and infections, often followed by fever; moreover, leukemic infiltration in different tissues, such as splenomegaly, leukemia cutis, lymphadenopathy, and hepatomegaly. This is caused by a decrease in red blood cells, platelets, or white blood cells, respectively. (1) In addition the aim and the main focus of this review article is that to discuss the new treatment method for AML with the help of NK cell immunotherapy . Natural killer (NK) cells are define a group of the innate immune system they are capable for decreasing infected and cancerous cells.based on the reachers studies NK cells, have been identified in roughly two dacateds ago , in addition NK cells are promising for adoptive immunotherapy due to they are able to target and destroy tumor cells without prior sensitisation (9)(10) This a reinforce by the facts that NK cell immunotherapy announced as safe and as a potential solution for AML treatments and also as a strong example for a effective treatment option for patients who struggle with advanced-stage leukemia.. Since then, the field of NK cell-based cancer therapy has grown significantly (7)(8). Thus to improving NK cell function, activate them with cytokines like IL-2 and IL-15.(9)(10) Currently, NK cell-based immunotherapies are considered promising strategies against tumours, particularly with slight side effects compared with cancer drugs and radiotherapy and other which mentioned above . The potential of NK cells in cancer immunotherapy is attracting substantial interest, especially in NK cells(9) Inaddition one instance that exemplifies that is NK cell therapy has been applied not only to hematologic tumours like leukaemia, lymphoma, and multiple myeloma but also to solid tumours like ovarian and breast cancers, achieving complete remission in fewer than 25% of patients. NK cells have been utilised for adoptive transfer, with the NK-92 cell line receiving FDA approval for clinical use. (11) For instance, NK cells are capable of identifying and destroying AML blasts through their activation receptors such as NKG2D and NCRs(11)
  • Methods: Methods: In The review was conducted through a systematic literature search using databases such as PubMed, Elsevier, Scince Direct and Web of Science . Keywords such as "AML" "AML cancer treatment," "personalized medicine," and CAR NKcell therapy and AML" were utilized to identify relevant articles. Selected studies were critically analyzed to summarize key findings regarding The NK cell therapeutic applications in this review are also investigated. all about treatment with CAR NK cells immunotherapy in AML, other case studies and clinical trials that have demonstrated integration. The findings will be useful to present a cohesive understanding of the role of CARNK92 cells in malignant cancer treatments.
  • Results: Result:Advances in AML cancer treatments are rooted in a better understanding of CAR NK cells immunotherapy predispositions and environmental risk factors. Immunotherapy has strong tumour-killing potency (9) Recently, studies indicated that Chimeric Antigen Receptor (CAR) technology has become a significant factor in immunotherapy. CARs can be categorized in three main leading types of immune cells, including CAR-T cells, CAR-NK cells, and CAR-Mac cells, which are essential for anti-cancer reactions .NK cells also have a different cytokine profile than T cells with the lower the risk of harsh consequences such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Likewise, NK cells can recognize various stress markers on cancer cells, As evidences shows CAR-NK cells hold great promise and potential for cancer therapy. Researchers are concentrating on engineering CAR-NK cells for treating acute myeloid leukemia (AML), CAR-NK cells redesigned to recognize CD123, which is a protein found on AML cells, with significant killing activity against these cells. Also, for enhancing CAR-NK activity, leading to increased proliferation and improved killing capacity. Researchers represent a gene for interleukin-15 (IL-15 For instance, an undeniable approach for treating CD33+leukaemia is to engineer NK cells with a chimeric receptor (cIgTCR) designed to identify and target CD33, which is a protein present on the surface of AML blasts. Several studies have illustrated that infusing CD33-CAR NK-92 cells is safe, with no significant side effects. The researchers investigate. These results suggest that CD33-CAR NK-92 cells are an achievable and safe therapeutic alternative specifically for treating acute myeloid leukemia (12). CD33-CAR-NK cells significantly reduce the leukemic burden, with no noticeable side effects. researchers modified our NK cells to specifically eliminate AML cancer cells (13)(14)
  • Conclusion: Conclusion:CAR-NK cell therapy has emerged as a radical approach in immunotherapy in cancer treatment, within huge offering the bright promise of durable remissions and high potential cures for patients with hematologic malignancies. It is critical to understand significant progress has been reached, on the other hand challenges still remain in this case of study in extending the critical benefits of CAR-NK cell therapy to patients with AML, researchers continue research efforts aimed at optimising CAR design, enhancing safety profiles, and expanding the applicability of CAR-NK cell therapy for the future of cancer immunotherapy.
  • Keywords: MLA ,Cancer, immunotherapy, CAR-NK, Cancer cure