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A combination immunotherapy consisting of the **PR1 leukemia-associated peptide vaccine** and **sargramostim** (granulocyte-macrophage colony-stimulating factor, GM-CSF), administered subcutaneously with Montanide adjuvant. PR1 is a nonapeptide derived from proteinase 3 and neutrophil elastase, antigens overexpressed in myeloid malignancies. Sargramostim is utilized as an immunologic adjuvant to enhance vaccine responses. The vaccine is designed to induce a cytotoxic T lymphocyte (CD8+) response specifically targeting leukemia cells. This combination has primarily been tested in patients with acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), and chronic myeloid leukemia (CML), especially those who are HLA-A*0201–positive. Clinical studies have established the combination is immunogenic and generally well-tolerated, but repeated dosing may lead to loss of high-avidity T-cell responses[1][2][3][4].
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