Myelodysplastic neoplasms (MDS) define clonal hematopoietic malignancies characterized by heterogeneous mutational and clinical spectra typically seen in the elderly. Curative treatment entails allogeneic hematopoietic stem cell transplant, which is often not a feasible option due to older age and significant comorbidities. Immunotherapy has the cytotoxic capacity to elicit tumor-specific killing with long-term immunological memory. While a number of platforms have emerged, therapeutic vaccination presents as an appealing strategy for MDS given its promising safety profile and amenability for commercialization. Several preclinical and clinical trials have investigated the efficacy of vaccines in MDS; these include peptide vaccines targeting tumor antigens, whole cell-based vaccines and dendritic cell-based vaccines. These therapeutic vaccines have shown acceptable safety profiles, but consistent clinical responses remain elusive despite robust immunological reactions. Combining vaccines with immunotherapeutic agents holds promise and requires further investigation. Herein, we highlight therapeutic vaccine trials while reviewing challenges and future directions of successful vaccination strategies in MDS.

中文翻译：

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疫苗：骨髓增生异常综合征的一种有前景的治疗方法

骨髓增生异常肿瘤 (MDS) 是一种克隆性造血系统恶性肿瘤，其特征是异质突变和临床谱，通常见于老年人。治愈性治疗需要同种异体造血干细胞移植，但由于年龄较大和严重的合并症，这通常不是可行的选择。免疫疗法具有细胞毒性能力，可引发具有长期免疫记忆的肿瘤特异性杀伤。尽管已经出现了许多平台，但鉴于其有前景的安全性和商业化的可行性，治疗性疫苗接种成为 MDS 的一种有吸引力的策略。多项临床前和临床试验研究了疫苗对 MDS 的功效；这些包括针对肿瘤抗原的肽疫苗、基于全细胞的疫苗和基于树突状细胞的疫苗。这些治疗性疫苗已显示出可接受的安全性，但尽管免疫学反应强劲，但一致的临床反应仍然难以捉摸。将疫苗与免疫治疗剂结合起来有希望，但需要进一步研究。在此，我们重点介绍治疗性疫苗试验，同时回顾 MDS 成功疫苗接种策略的挑战和未来方向。