Immune-enriched acute myeloid leukemia (AML) may be responsive to immunotherapy that is tailored to the bone marrow tumor microenvironment, according to a report presented at the ASCO-SITC Clinical Immuno-Oncology Symposium (January 25-27, 2018; San Francisco, CA).
Tumor microenvironment, including immune and inflammatory cells, plays a major role in determining tumor phenotype. Analyzing the tumor microenvironment of acute myeloid leukemias may offer new information regarding patient outcomes, novel biomarkers, and patient stratification.
Jayakumar Vadakekolathu, PhD, Nottingham Trent University (United Kingdom), and colleagues conducted a pan-cancer analysis of bone marrow samples in patients with AML to correlate transcriptomic and proteomic profiles with patient outcomes. Researchers utilized nCounter system from NanoString Technologies to characterize bone marrow specimens of 42 children and 28 adults with AML, as well as identify heterogeneous immune profiles that correlat with relapse-free survival (RFS) and overall survival (OS). A total of 90 bone marrow samples (63 from de novo AML, 18 from AML in complete remission, and 9 from relapsed AML) were analyzed with the RNA Pan-Cancer Immune Profiling Panel.
Researchers identified two distinct immune gene expression profiles that were largely age-differentiated: myeloid-enriched specimens (included 26 children and eight adults) and myeloid-depleted specimens (included nine children and 18 adults).
Results of the analysis showed that relapse-free survival (2.2 vs 18.3 months; HR, 2.58; P = .0064) and OS (6.3 vs 22.4 months; HR, 2.39; P = .017) were significantly shorter in patients with myeloid-enriched AMLs compared with myeloid-depleted AMLs, respectively.
These results shed light on heterogeneous immune profiles in children and adults with AML, Dr Vadakekolathu and colleagues wrote, and may have implications for the development of new treatment strategies.
“High degrees of molecular complexity in AML present a considerable challenge in clinical implementation, and there is an urgent need to discover better biomarkers to identify high-risk patients before starting chemotherapy, which would enable testing of investigational therapeutic strategies in clinical trials,” he said in his presentation.—Zachary Bessette