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2016 ; 36
(2
): 179-191
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Immunostimulatory Effects of Melphalan and Usefulness in Adoptive Cell Therapy
with Antitumor CD4+ T Cells
#MMPMID27910767
Kuczma M
; Ding ZC
; Zhou G
Crit Rev Immunol
2016[]; 36
(2
): 179-191
PMID27910767
show ga
The alkylating agent melphalan is used in the treatment of hematological
malignancies, especially multiple myeloma. In the past, the usefulness of
melphalan has been solely attributed to its cytotoxicity on fastgrowing cancerous
cells. Although the immunomodulatory effects of melphalan were suggested many
years ago, only recently has this aspect of melphalan's activity begun to be
elucidated at the molecular level. Emerging evidence indicates that melphalan can
foster an immunogenic microenvironment by inducing immunogenic cell death (ICD)
as characterized by membrane translocation of endoplasmic reticulum protein
calreticulin (CRT) and by release of chromatin-binding protein high-mobility
group box 1 (HMGB1). In addition, the lympho-depletive effect of melphalan can
induce the release of pro-inflammatory cytokines and growth factors, deplete
regulatory T cells, and create space to facilitate the expansion of infused
tumor-reactive T cells. These features suggest that melphalan can be used as a
preparative chemotherapy for adoptive T-cell therapy. This notion is supported by
our recent work demonstrating that the combination of melphalan and adoptive
transfer of tumor-reactive CD4+ T cells can mediate potent antitumor effects in
animal models. This review summarizes the recent advances in understanding and
utilizing the immunomodulatory effects of melphalan.