Title:Immunoliposomes in Acute Myeloid Leukaemia Therapy: An Overview of Possible Targets and Obstacles
Volume: 26
Issue: 28
Author(s): Aditi Singh, Nikolai Norevik Myklebust, Sarah Marie Vie Furevik, Ragnhild Haugse and Lars Herfindal*
Affiliation:
- Centre for Pharmacy, Department of Clinical Science, University of Bergen, Bergen,Norway
Keywords:
Acute myeloid leukemia, liposomes, antibodies, immunoliposomes, bone marrow, pharmacy, production.
Abstract: Acute Myeloid Leukaemia (AML) is the neoplastic transformation of Hematopoietic
Stem Cells (HSC) and relapsed disease is a major challenge in the treatment. Despite
technological advances in the field of medicine and our heightened knowledge regarding the
pathogenesis of AML, the initial therapy of “7+3” Cytarabine and Daunorubicin has remained
mainly unchanged since 1973. AML is a disease of the elderly, and increased morbidity in
this patient group does not allow the full use of the treatment and drug-resistant relapse is
common.
Nanocarriers are drug-delivery systems that can be used to transport drugs to the bone marrow
and target Leukemic Stem Cells (LSC), conferring less side-effects compared to the free-drug
alternative. Nanocarriers also can be used to favour the transport of drugs that otherwise
would not have been used clinically due to toxicity and poor efficacy. Liposomes are a type of
nanocarrier that can be used as a dedicated drug delivery system, which can also have active
ligands on the surface in order to interact with antigens on the target cells or tissues. In addition
to using small molecules, it is possible to attach antibodies to the liposome surface, generating
so-called immunoliposomes. By using immunoliposomes as a drug-delivery system, it
is possible to minimize the toxic side effects caused by the chemotherapeutic drug on healthy
organs, and at the same time direct the drugs towards the remaining AML blasts and stem
cells.
This article aims to explore the possibilities of using immunoliposomes as a drug carrier in
AML therapy. Emphasis will be on possible target molecules on the AML cells, leukaemic
stem cells, as well as bone marrow constituents relevant to AML therapy. Further, some conditions
and precautions that must be met for immunoliposomes to be used in AML therapy
will be discussed.