A research team from the National Center for Microbiology in the United States managed to find different biomarkers that could identify patients with chronic myelogenous leukemia who were discontinued after their disease control was achieved and had a higher risk of recurrence.
A kind survey Led by the team Mayte Coiras, Located at the National Center for Microbiology ISCIII, Reveal which patients Chronic myeloid leukemia Once the disease is under control, they have a better chance of safely giving up treatment.The work was published in Journal of Clinical Medicine.
The research is based on immunological analysis of different responses to immunoglobulins. immune system When chronic myelogenous leukemia (CML) appears, Rare cancer And it belongs to the so-called myeloproliferative tumor.Chronic myelogenous leukemia can be called Tyrosine kinase inhibitor (TKI, its English abbreviation), which has greatly increased the survival rate in recent years, about 90%.
TKIs mainly act on the BCR-ABL protein, which can cause chronic myeloid leukemia, which will cause an anti-leukemia response, thereby blocking the effect of the protein. In addition, it will increase the production of immune system cells, especially CD8 + lymphocytes. T and “Natural Killer” (NK).
After a few years, because the molecular response of the immune system can control the disease, most patients can stop treatment. However, due to unidentified reasons, half of the patients who gave up treatment while controlling CML relapsed and lost immune control over the remaining cancer cells.
This new research is based on the following sample 93 patients at different disease stages, A classification has been established based on the population with high and low risk of recurrence after giving up TKI treatment.
Key immune mode
According to this study, the following immune modes have poorer disease control and higher risk of recurrence: when the levels of cytotoxic cells such as NK, NKT, CD8 + and TCRγβ+ are low; when the activation on the surface of NK and NKT cells When the expression of the receptor CD16 decreases; When the synthesis of pro-inflammatory cytokines and proteases in the NK cells changes; When the human leukocyte antigen (HLA) E * 0103 and the BX haplotype of the KIR gene appear homozygous and other processes Time.
According to the influence of these parameters, divide patients into groups with higher or lower risk 90% reliabilityTherefore, the above-mentioned immune pattern can be regarded as a predictive biomarker of the risk of MCL recurrence in patients who discontinue treatment with TKI.
The author explains that once the disease is under control, each patient’s immune system may have more or less ability to continue to fight the remaining cancer cells in the body, and this ability does not have to depend on the type of treatment chosen or among other factors. In the past, cytomegalovirus may also be infected.
He believes that the results may have important clinical application value: “These biomarkers will help determine which patients with chronic myelogenous leukemia have the lowest risk of stopping treatment without causing cancer recurrence.”
The possible uses of the biomarkers discovered in the study in clinical practice will continue to be studied in a larger cohort of patients, with more controlled time follow-up.
Coiras M. et al.: Determination of immunological parameters as a predictive biomarker for relapse in patients with chronic myeloid leukemia without treatment remission. Journal of Clinical Medicine. December 25, 2020; 10(1): E42. doi: 10.3390 / jcm10010042.