Service d’hématologie adulte, Hôpital Saint-Louis, Paris, Unité INSERM U662, Institut universitaire d’hématologie, Hôpital Saint-Louis, Paris, Service de thérapie cellulaire, Hôpital Saint-Louis, Paris
Chronic myeloid leukemia is considered as a model in the field of anti-tumor immunity. Before the era of the tyrosine kinase inhibitor (TKI) imatinib, allogeneic hematopoietic stem cell transplantation, by means of its graft-versus leukemia effect, was considered as the only curative therapy. To face the emergence of resistance to imatinib and the persistence of quiescent stem cell insensitive to imatinib treatment, varying strategies are currently being developed such as 2
nd generation TKI or the combination of TKI to immune targeted therapies (IFN-α, vaccination approaches). Several effects of imatinib on the immune system have been published, sometimes in contradictory ways. A predominantly immunosuppressive impact on T-lymphocytes and antigen presenting cells was reported, but the molecular targets driving this property remain poorly identified. Clinical trials assessing the efficacy of imatinib in association with immune targeted therapies, either referenced (IFN-α, allogeneic stem cell transplantation, donor lymphocyte injection) or investigational (vaccination with dendritic cells, peptide…), should include specific immunomonitoring.