Increased proportion of mature NK cells is associated with successful imatinib discontinuation in chronic myeloid leukemia

Leukemia. 2017 May;31(5):1108-1116. doi: 10.1038/leu.2016.360. Epub 2016 Nov 28.

Abstract

Recent studies suggest that a proportion of chronic myeloid leukemia (CML) patients in deep molecular remission can discontinue the tyrosine kinase inhibitor (TKI) treatment without disease relapse. In this multi-center, prospective clinical trial (EURO-SKI, NCT01596114) we analyzed the function and phenotype of T and NK cells and their relation to successful TKI cessation. Lymphocyte subclasses were measured from 100 imatinib-treated patients at baseline and 1 month after the discontinuation, and functional characterization of NK and T cells was done from 45 patients. The proportion of NK cells was associated with the molecular relapse-free survival as patients with higher than median NK-cell percentage at the time of drug discontinuation had better probability to stay in remission. Similar association was not found with T or B cells or their subsets. In non-relapsing patients the NK-cell phenotype was mature, whereas patients with more naïve CD56bright NK cells had decreased relapse-free survival. In addition, the TNF-α/IFN-γ cytokine secretion by NK cells correlated with the successful drug discontinuation. Our results highlight the role of NK cells in sustaining remission and strengthen the status of CML as an immunogenic tumor warranting novel clinical trials with immunomodulating agents.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Case-Control Studies
  • Cytokines / metabolism
  • Dasatinib / therapeutic use
  • Disease-Free Survival
  • Humans
  • Imatinib Mesylate / therapeutic use*
  • Killer Cells, Natural / cytology*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology
  • Lymphocyte Count
  • Lymphocyte Subsets / cytology
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrimidines / therapeutic use
  • Withholding Treatment

Substances

  • Cytokines
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Imatinib Mesylate
  • nilotinib
  • Dasatinib

Associated data

  • ClinicalTrials.gov/NCT01596114