CML vaccines as a paradigm of the specific immunotherapy of cancer

T cells are implicated in the effective control of chronic myeloid leukemia (CML). Recently, several clinical observations supported by laboratory dat a, indicate the presence of CML-specific T cells. Many proteins potentially act as leukemia-specific antigens for MHC-restricted cytotoxicity in CML. These include the bcr-abl fusion protein, myeloid-specific differentiation antigens and minor histocompatibility antigens. There is recent evidence to suggest that bcr-abl-junctional peptides are capable of eliciting both CD4 and CD8 responses in normal healthy donors and in patients with CML. Moreo ver, T cell lines can be generated that react with autologous or HLA-matche d fresh CML cells, suggesting that the bcr-abl fusion protein can be proces sed and expressed in the MHC cell surface molecules. Clinical trials exploi ting the new understanding of the immunology of CML are underway. (C) 2000 Harcourt Publishers Ltd.