Histamine dihydrochloride and low-dose interleukin-2 in an emerging landscape of relapse prevention in acute myeloid leukemia

Effective strategies to maintain complete remission in adults with acute myeloid leukemia (AML) are critically needed. Early clinical trials aimed at preventing relapse in the postconsolidation phase explored prolonged chemotherapy, single-agent immunotherapy, and hybrid chemo-immunotherapy, but non...

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Main Authors: Malin S. Nilsson, Anna Martner, Lovisa Wennström, Markus Hansson, Fredrik B. Thorén, Kristoffer Hellstrand
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Therapeutic Advances in Hematology
Online Access:https://doi.org/10.1177/20406207251351086
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author Malin S. Nilsson
Anna Martner
Lovisa Wennström
Markus Hansson
Fredrik B. Thorén
Kristoffer Hellstrand
author_facet Malin S. Nilsson
Anna Martner
Lovisa Wennström
Markus Hansson
Fredrik B. Thorén
Kristoffer Hellstrand
author_sort Malin S. Nilsson
collection DOAJ
description Effective strategies to maintain complete remission in adults with acute myeloid leukemia (AML) are critically needed. Early clinical trials aimed at preventing relapse in the postconsolidation phase explored prolonged chemotherapy, single-agent immunotherapy, and hybrid chemo-immunotherapy, but none of these approaches produced practice-changing results. More recent trials have identified efficacious remission maintenance strategies, including (1) midostaurin or quizartinib for patients with FLT3 -mutated AML, (2) oral azacitidine for older AML patients, and (3) immunotherapy with histamine dihydrochloride and low-dose interleukin-2 (HDC/IL-2) for younger patients. In this review, we examine key phase III trial and follow-up study results for approved remission maintenance therapies, with a particular focus on HDC/IL-2. We discuss clinical efficacy in relation to patient age and anti-leukemic immunity as well as leukemic cell chemosensitivity, chromosomal integrity, and mutational profiles. Finally, we propose a role for HDC/IL-2 within an evolving landscape of strategies to achieve durable remission in a broader population of AML patients.
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series Therapeutic Advances in Hematology
spelling doaj-art-9223c4ebb1b8412bbd85497fce52ee252025-08-20T02:35:24ZengSAGE PublishingTherapeutic Advances in Hematology2040-62152025-06-011610.1177/20406207251351086Histamine dihydrochloride and low-dose interleukin-2 in an emerging landscape of relapse prevention in acute myeloid leukemiaMalin S. NilssonAnna MartnerLovisa WennströmMarkus HanssonFredrik B. ThorénKristoffer HellstrandEffective strategies to maintain complete remission in adults with acute myeloid leukemia (AML) are critically needed. Early clinical trials aimed at preventing relapse in the postconsolidation phase explored prolonged chemotherapy, single-agent immunotherapy, and hybrid chemo-immunotherapy, but none of these approaches produced practice-changing results. More recent trials have identified efficacious remission maintenance strategies, including (1) midostaurin or quizartinib for patients with FLT3 -mutated AML, (2) oral azacitidine for older AML patients, and (3) immunotherapy with histamine dihydrochloride and low-dose interleukin-2 (HDC/IL-2) for younger patients. In this review, we examine key phase III trial and follow-up study results for approved remission maintenance therapies, with a particular focus on HDC/IL-2. We discuss clinical efficacy in relation to patient age and anti-leukemic immunity as well as leukemic cell chemosensitivity, chromosomal integrity, and mutational profiles. Finally, we propose a role for HDC/IL-2 within an evolving landscape of strategies to achieve durable remission in a broader population of AML patients.https://doi.org/10.1177/20406207251351086
spellingShingle Malin S. Nilsson
Anna Martner
Lovisa Wennström
Markus Hansson
Fredrik B. Thorén
Kristoffer Hellstrand
Histamine dihydrochloride and low-dose interleukin-2 in an emerging landscape of relapse prevention in acute myeloid leukemia
Therapeutic Advances in Hematology
title Histamine dihydrochloride and low-dose interleukin-2 in an emerging landscape of relapse prevention in acute myeloid leukemia
title_full Histamine dihydrochloride and low-dose interleukin-2 in an emerging landscape of relapse prevention in acute myeloid leukemia
title_fullStr Histamine dihydrochloride and low-dose interleukin-2 in an emerging landscape of relapse prevention in acute myeloid leukemia
title_full_unstemmed Histamine dihydrochloride and low-dose interleukin-2 in an emerging landscape of relapse prevention in acute myeloid leukemia
title_short Histamine dihydrochloride and low-dose interleukin-2 in an emerging landscape of relapse prevention in acute myeloid leukemia
title_sort histamine dihydrochloride and low dose interleukin 2 in an emerging landscape of relapse prevention in acute myeloid leukemia
url https://doi.org/10.1177/20406207251351086
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