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Predictive Biomarkers of Treatment-Free Remission in CML Under Study

By: Kelly M. Hennessey, PhD
Posted: Friday, July 24, 2020

Tyrosine kinase inhibitor (TKI) treatments improve survival rates in patients with chronic myeloid leukemia (CML), yet biomarker predictors of treatment-free remission are lacking. After completing a comprehensive analysis of the immune cell populations of patients with CML at TKI cessation, Yazad D. Irani, PhD, of the South Australia Health and Medical Research Institute, Adelaide, and colleagues developed a measurable indicator (an effector-suppressor score) to predict treatment-free remission. They propose that both immune suppressors and effectors in the immunobiology may be at the heart of successful treatment-free remission. Their results were published in the British Journal of Haematology.

The researchers used absolute natural killer (NK) cell (effector), FoxP3+ regulatory T cells, and monocytic myeloid-derived suppressor cell counts from patients with CML at TKI cessation to create their statistical model. A total of 59 patients from the Australia New Zealand Clinical Trials Registry were included in this study. Researchers used data from the CML10 and CML8 cohorts to validate their model.

Of the study population, 45.8% (n = 27) achieved treatment-free remission; those patients had higher levels of NK cells that were expressing activating NK receptors; however, there was no difference in proportions of CD4+ or CD8+ T cells. Researchers also found that patients in treatment-free remission had decreased numbers of regulatory T cells and monocytic myeloid-derived suppressor cells, suggesting that the effector and suppressor arms of the immune system influence treatment-free remission.

According to the investigators, their findings may help to identify patients most likely to have successful treatment-free remission early so as to avoid unnecessary therapy. “Our score could also identify patients at higher risk of relapse for interventional strategies, such as vaccination or other immunotherapy, to improve their chances of successful treatment-free remission,” they added.

Disclosure: The study authors’ disclosures can be found at onlinelibrary.wiley.com.



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