Use of Roquinimex in the Myeloid Leukemias

The increasing use of allogeneic bone marrow transplantation has led to unequivocal evidence for the efficacy of immunotherapy in the treatment of acute leukemia. It is now known that syngeneic transplantation, T lymphocyte depletion and the absence of graft-versus-host disease all increase the risk of relapse following allogeneic transplantation for the myeloid leukemias, both acute and chronic. Leukemia-specific immune responses appear to play a major role in the therapy of the myeloid leukemias. In recent years attempts have been made to better characterize and effectively utilize these antileukemic immune responses. A beneficial effect is more likely to be seen when the tumor burden is low and such efforts have therefore concentrated on clinical states of minimal residual disease. This review will discuss the role of the novel immunomodulator roquinimex following autologous bone marrow transplantation for myeloid leukemias, and will focus on recent experience and ongoing clinical trials in acute myelogenous leukemia and chronic myelogenous leukemia.