Flow cytometry and targeted immune transcriptomics identify distinct profiles in patients with chronic myeloid leukemia receiving tyrosine kinase inhibitors with or without interferon-α

被引:23
作者
Alves, Raquel [1 ,2 ,3 ,4 ]
McArdle, Stephanie E. B. [5 ]
Vadakekolathu, Jayakumar [5 ]
Goncalves, Ana Cristina [1 ,2 ,3 ,4 ]
Freitas-Tavares, Paulo [6 ]
Pereira, Amelia [3 ,7 ]
Almeida, Antonio M. [8 ,9 ]
Sarmento-Ribeiro, Ana Bela [1 ,2 ,3 ,4 ,6 ]
Rutella, Sergio [5 ,10 ]
机构
[1] Univ Coimbra FMUC, Fac Med, Lab Oncobiol & Hematol, Coimbra, Portugal
[2] Univ Coimbra FMUC, Univ Clin Hematol, Fac Med, Coimbra, Portugal
[3] FMUC, Grp Environm Genet & Oncobiol CIMAGO, Coimbra Inst Clin & Biomed Res iCBR, Coimbra, Portugal
[4] Univ Coimbra, CIBB, Coimbra, Portugal
[5] Nottingham Trent Univ, John van Geest Canc Res Ctr, Sch Sci & Technol, Clifton Campus, Nottingham NG11 8NS, England
[6] CHUC, Clin Hematol Dept, Coimbra, Portugal
[7] HDFF, Internal Med Serv, Figueira Da Foz, Portugal
[8] Hosp Luz, Lisbon, Portugal
[9] Univ Catolica Portuguesa Lisboa, CIIS, Lisbon, Portugal
[10] Nottingham Trent Univ, Sch Sci & Technol, CHAUD, Nottingham, England
关键词
Chronic myeloid leukemia; Interferon; Immunotherapy; Gene expression profiling; Immune monitoring; GASTROINTESTINAL STROMAL TUMOR; CD56(BRIGHT) NK CELLS; T-CELLS; IMATINIB DISCONTINUATION; NANOSTRING TECHNOLOGIES; SUPPRESSOR-CELLS; RESPONSES; CML; THERAPY; IFN;
D O I
10.1186/s12967-019-02194-x
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background Tumor cells have evolved complex strategies to escape immune surveillance, a process which involves NK cells and T lymphocytes, and various immunological factors. Indeed, tumor cells recruit immunosuppressive cells [including regulatory T-cells (Treg), myeloid-derived suppressor cells (MDSC)] and express factors such as PD-L1. Molecularly targeted therapies, such as imatinib, have off-target effects that may influence immune function. Imatinib has been shown to modulate multiple cell types involved in anti-cancer immune surveillance, with potentially detrimental or favorable outcomes. Imatinib and other tyrosine kinase inhibitors (TKIs) in chronic myeloid leukemia (CML) have dramatically changed disease course. Our study aimed to characterize the different populations of the immune system in patients with CML affected by their treatment. Methods Forty-one patients with CML [33 treated with TKIs and 8 with TKIs plus interferon (IFN)-alpha] and 20 controls were enrolled in the present study. Peripheral blood populations of the immune system [referred to as the overview of immune system (OVIS) panel, Treg cells and MDSCs] and PD-1 expression were evaluated by flow cytometry. The immunological profile was assessed using the mRNA Pan-Cancer Immune Profiling Panel and a NanoString nCounter FLEX platform. Results Patients receiving combination therapy (TKIs + IFN-alpha) had lower numbers of lymphocytes, particularly T cells [838/mu L (95% CI 594-1182)] compared with healthy controls [1500/mu L (95% CI 1207 - 1865), p = 0.017]. These patients also had a higher percentage of Treg (9.1%) and CD4(+)PD-1(+) cells (1.65%) compared with controls [Treg (6.1%) and CD4(+)/PD-1(+)(0.8%); p <= 0.05]. Moreover, patients treated with TKIs had more Mo-MDSCs (12.7%) whereas those treated with TKIs + IFN-alpha had more Gr-MDSC (21.3%) compared to controls [Mo-MDSC (11.4%) and Gr-MDSC (8.48%); p <= 0.05]. CD56(bright) NK cells, a cell subset endowed with immune-regulatory properties, were increased in patients receiving TKIs plus IFN-alpha compared with those treated with TKIs alone. Interestingly, serum IL-21 was significantly lower in the TKIs plus IFN-alpha cohort. Within the group of patients treated with TKI monotherapy, we observed that individuals receiving 2nd generation TKIs had lower percentages of CD4(+) Treg (3.63%) and Gr-MDSC (4.2%) compared to patients under imatinib treatment (CD4(+) Treg 6.18% and Gr-MDSC 8.2%), but higher levels of PD-1-co-expressing CD4(+) cells (1.92%). Conclusions Our results suggest that TKIs in combination with IFN-alpha may promote an enhanced immune suppressive state.
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页数:15
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