Fig. 1

Overview of immune escape mechanisms in AML after allogeneic stem cell transplantation. The various immune evasion strategies include genomic loss or downregulation of HLA (1), upregulation of inhibitory or downregulation of activating receptors and the corresponding ligands (2), exhausted and dysfunctional immune effector cells (3a), an altered metabolic environment (3b) as well as an increase of immunosuppressive cell types (MDSCs, M2 macrophages and TAMs, T regs) and vascular remodelling of the AML niche cells (3c). This figure was created using Biorender. ¹ Recent studies indicate that epigenetic downregulation could also affect HLA class I [26]. AML blast: acute myeloid leukemia blast, LSC: Leukemic stem cell, DC: dendritic cell, NK cell: Natural killer cell, MSC: mesenchymal stem cell, MDSC: myeloid derived suppressor cell, TAM: tumor associated macrophage. ↑ indicates upregulation, whereas ↓ marks downregulation