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免疫检查点蛋白与急性髓系白血病患者治疗结果之间的关联

The Association between Immune Checkpoint Proteins and Therapy Outcomes in Acute Myeloid Leukaemia Patients.

作者信息

Bolkun Lukasz, Tynecka Marlena, Walewska Alicja, Bernatowicz Malgorzata, Piszcz Jaroslaw, Cichocka Edyta, Wandtke Tomasz, Czemerska Magdalena, Wierzbowska Agnieszka, Moniuszko Marcin, Grubczak Kamil, Eljaszewicz Andrzej

机构信息

Department of Haematology, Medical University of Bialystok, 15-276 Bialystok, Poland.

Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, 15-269 Bialystok, Poland.

出版信息

Cancers (Basel). 2023 Sep 9;15(18):4487. doi: 10.3390/cancers15184487.

Abstract

The development of novel drugs with different mechanisms of action has dramatically changed the treatment landscape of AML patients in recent years. Considering a significant dysregulation of the immune system, inhibitors of immune checkpoint (ICI) proteins provide a substantial therapeutic option for those subjects. However, use of ICI in haematological malignancies remains very limited, in contrast to their wide use in solid tumours. Here, we analysed expression patterns of the most promising selected checkpoint-based therapeutic targets in AML patients. Peripheral blood of 72 untreated AML patients was used for flow cytometric analysis. Expression of PD-1, PD-L1, CTLA-4, and B7-H3 was assessed within CD4+ (Th) lymphocytes and CD33+ blast cells. Patients were stratified based on therapy outcome and cytogenetic molecular risk. AML non-responders (NR) showed a higher frequency of PD-1 in Th cells compared to those with complete remission (CR). Reduced blast cell level of CTLA-4 was another factor differentiating CR from NR subjects. Elevated levels of PD-1 were associated with a trend for poorer patients' survival. Additionally, prognosis for AML patients was worse in case of a higher frequency of B7-H3 in Th lymphocytes. In summary, we showed the significance of selected ICI as outcome predictors in AML management. Further, multicentre studies are required for validation of those data.

摘要

近年来,具有不同作用机制的新型药物的研发极大地改变了急性髓系白血病(AML)患者的治疗格局。考虑到免疫系统的显著失调,免疫检查点(ICI)蛋白抑制剂为这些患者提供了一种重要的治疗选择。然而,与ICI在实体瘤中的广泛应用形成对比的是,其在血液系统恶性肿瘤中的应用仍然非常有限。在此,我们分析了AML患者中最有前景的基于检查点的治疗靶点的表达模式。使用72例未经治疗的AML患者的外周血进行流式细胞术分析。在CD4 +(Th)淋巴细胞和CD33 +原始细胞内评估PD-1、PD-L1、CTLA-4和B7-H3的表达。根据治疗结果和细胞遗传学分子风险对患者进行分层。与完全缓解(CR)的患者相比,AML无反应者(NR)的Th细胞中PD-1的频率更高。CTLA-4原始细胞水平降低是区分CR和NR患者的另一个因素。PD-1水平升高与患者生存较差的趋势相关。此外,Th淋巴细胞中B7-H3频率较高时,AML患者的预后更差。总之,我们证明了所选ICI作为AML治疗结果预测指标的重要性。此外,需要多中心研究来验证这些数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bafc/10526931/0f32773de555/cancers-15-04487-g001.jpg

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