Translational mini-review series on vaccines: Peptide vaccines for myeloid leukaemias

The graft-versus-leukaemia (GVL) effect following allogeneic stem cell transplantation is clear evidence that T lymphocytes can control and eliminate myeloid leukaemias. The successful identification of a range of leukaemia specific antigens (LSA) in recent years has stimulated efforts to induce leukaemia specific T cell responses to these antigens with peptide vaccines. An ideal LSA should be restricted in its expression to leukaemia including progenitor cells, intrinsically connected with the leukaemic phenotype, and capable of inducing strong cytotoxic T cell responses to the leukaemia. Peptides from three well-characterized LSA, the breakpoint cluster region-abelson (BCR-ABL) fusion protein of chronic myelogenous leukaemia, proteinase-3 and Wilms tumour 1 protein, serve as the basis for several clinical trials using peptide and adjuvants to treat patients with a variety of myeloid malignancies. Preliminary results from these studies indicate that these peptides induce immune responses which can translate into clinical responses which include complete remissions from leukaemia. These promising early results point the way to optimizing the administration of peptide vaccines and suggest ways of combining vaccination with allogeneic stem cell transplantation to boost GVL effects.