Figure 1.

Main mechanisms for vaccine-based immunotherapy production and function in acute myeloid leukemia (AML). Top left: CD14+ monocytes or blast cells are collected from peripheral blood and differentiated into immature dendritic cells (DCs) in culture with IL-4 and GM-CSF. Mature DCs loaded with tumor-associated antigens (TAA) are then obtained by specific procedures (e.g., mRNA electroporation, pulsing with apoptotic AML cells or their lysates, or directly with peptides). Mature TAA-loaded DCs are reinfused in patients. Bottom left: peptide vaccine production. Preselected peptides (e.g., WT1, RHAMM) are prepared in a laboratory as modified constructs or integrated with other molecules and reinfused in patients. In lymph nodes, they are internalized, processed, and exposed by antigen-presenting cells (APC), particularly Ds. On the right, the terminal stage of vaccine therapy is represented, in which DCs induce the activation of immune effectors CD8+ cytotoxic lymphocytes (CTLs) and NK-cells, which attack, in turn, AML blasts.