Vadakekolathu Jayakumar, Minden Mark D, Hood Tressa, Church Sarah E, Reeder Stephen, Altmann Heidi, Sullivan Amy H, Viboch Elena J, Patel Tasleema, Ibrahimova Narmin, Warren Sarah E, Arruda Andrea, Liang Yan, Smith Thomas H, Foulds Gemma A, Bailey Michael D, Gowen-MacDonald James, Muth John, Schmitz Marc, Cesano Alessandra, Pockley A Graham, Valk Peter J M, Löwenberg Bob, Bornhäuser Martin, Tasian Sarah K, Rettig Michael P, Davidson-Moncada Jan K, DiPersio John F, Rutella Sergio
John van Geest Cancer Research Centre, Nottingham Trent University, Nottingham NG11 8NS, UK.
Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada.
Sci Transl Med. 2020 Jun 3;12(546). doi: 10.1126/scitranslmed.aaz0463.
Acute myeloid leukemia (AML) is a molecularly and clinically heterogeneous hematological malignancy. Although immunotherapy may be an attractive modality to exploit in patients with AML, the ability to predict the groups of patients and the types of cancer that will respond to immune targeting remains limited. This study dissected the complexity of the immune architecture of AML at high resolution and assessed its influence on therapeutic response. Using 442 primary bone marrow samples from three independent cohorts of children and adults with AML, we defined immune-infiltrated and immune-depleted disease classes and revealed critical differences in immune gene expression across age groups and molecular disease subtypes. Interferon (IFN)-γ-related mRNA profiles were predictive for both chemotherapy resistance and response of primary refractory/relapsed AML to flotetuzumab immunotherapy. Our compendium of microenvironmental gene and protein profiles provides insights into the immuno-biology of AML and could inform the delivery of personalized immunotherapies to IFN-γ-dominant AML subtypes.
急性髓系白血病(AML)是一种在分子和临床方面均具有异质性的血液系统恶性肿瘤。尽管免疫疗法对于AML患者而言可能是一种颇具吸引力的治疗方式,但预测哪些患者群体以及何种癌症类型会对免疫靶向治疗产生反应的能力仍然有限。本研究以高分辨率剖析了AML免疫结构的复杂性,并评估了其对治疗反应的影响。我们使用来自三个独立队列的442份儿童和成人AML患者的原发性骨髓样本,定义了免疫浸润和免疫耗竭疾病类别,并揭示了不同年龄组和分子疾病亚型之间免疫基因表达的关键差异。干扰素(IFN)-γ相关的mRNA谱可预测原发性难治性/复发性AML对化疗的耐药性以及对flotetuzumab免疫疗法的反应。我们的微环境基因和蛋白质谱汇编为AML的免疫生物学提供了见解,并可为向以IFN-γ为主的AML亚型提供个性化免疫疗法提供依据。