“A.B.C.” of Immunotherapy in Hematological Malignancies…Promise and Perils

Abstract The treatment landscape of hematological malignancies has been evolving at an extremely fast pace. Hematological are diverse and distinct from solid tumors. These constitute challenges, which also unique opportunities for immunotherapy. five categories immunotherapies that have found success in the management allogeneic hematopoietic stem cell transplant, monoclonal antibodies innovative designs, immune checkpoint inhibitors, chimeric antigen receptor (CAR) T cells, B targeting small immunomodulatory molecules. Allogeneic transplant rightly called our bluntest weapon is oldest form successful Alternate donor transplants improvement supportive care improved scope this immunotherapy option. Among antibodies, rituximab forms prototype on over a dozen other developed. bispecific T-cell engager (BiTE) blinatumomab engages cytotoxic CD3 cells with CD19 acute lymphoblastic leukemia (ALL) effective method relapsed refractory ALL. Immune inhibitors established their role high PD-L1 expression, including Hodgkin's lymphoma primary mediastinal (BCL). Small drugs downstream signaling through BTK SYK PI3K (idelalisib), BCL-2 (venetoclax), imide (lenalidomide) emerged as exciting therapeutic avenues CAR one most promising adoptive living or serial killers to keep patients alive. genetically engineered, autologous combine cytotoxicity antigen-binding specificity CARs. CARs antigen-specific but major histocompatibility complex/human leukocyte antigen-independent. There approved products leukemias, lymphoma, multiple myeloma. past present really future looks incredibly promising. challenges include widening availability affordability beyond specialized centers, identification potentially predictive biomarkers response, experience complications these novel agents. combinational approach might be way forward complement strategies harness system improve survival good quality life.