Monitoring of (Leukemia-Specific) Immune Cells in Stages, Treatment Groups and in the Course of Disease and Therapy Contributes to Qualify Antileukemic Potential and Survival in Patients with AML

Various AML treatment regimens might trigger different immunological mechanisms against leukemic cells. The role of different immune cell subsets in the mediation of antileukemic processes is not clear. In this study, we longitudinally assessed (leukemia specific) immune subtype compositions in 17 AML patients before stem cell transplantation (SCT) at different timepoints in the course and in different stages of the disease using flow cytometry. Further we correlated immune cell compositions with patients' response to induction therapy and the median survival (3.8 months in our cohort) of the patients. Finally, we compared immune cell profiles from patients before and after SCT. (1) Patients in CR (compared to dgn and PD) were characterized by higher frequencies of leukemia-derived DC (DCleu), (leukemia-specific-IFNg or TNFα producing or CD107a degranulating) anti-tumor relevant T cells (Tgd, Tβ7), central/effector memory cells (Tcm, Tem), alongside with lower frequencies of (leukemia-specific) regulatory T cells. (2) Patients with higher frequencies of (leukemia-specific) antitumor relevant T cells, (leukemia-specific) memory T cells and NK cells demonstrated a prolonged median survival time and/or responded better to induction (RTI) treatment (3) Comparing patients before and after SCT, only minimal differences were observed. However, patients in CR_preSCT exhibited higher frequencies of DC, Tcm, Tβ7 and leukemia-specific iNKT cells compared to patients in CR_postSCT. (1) Immune monitoring qualifies to quantify (leukemia-specific) immune cells in different stages and under different treatment strategies in the course of AML. (2) Higher frequencies of activating and antitumor relevant leukemia-specific immune cell subtypes found after 'costimulatory' (especially KitM induced) treatment' and in CR. (3) In particular, DC/DCleu, (leukemia-specific) antitumor-relevant T (memory) and NK cells seem to dominate in CR and positively influence RTI and survival. (4) Monitoring of (leukemia-specific) immune cell subtypes contribute to quantify individual AML patients' antileukemic potential in different stages and treatment groups and also could be used to predict patients' survival.