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Circulating Monocytic Myeloid-Derived Suppressor Cells Are Elevated and Associated with Poor Prognosis in Acute
Huiping Wang1, Qianshan Tao1, Zhitao Wang1
1Department of Hematology, The Second Hospital of Anhui Medical University, and Hematology Research Center, Anhui Medical University, Hefei, Anhui, China.
Insights
Monocytic myeloid-derived suppressor cells (M-MDSCs) are elevated in acute myeloid leukemia (AML) patients compared to healthy controls. High M-MDSC levels indicate a poor prognosis and may serve as a prognostic indicator for AML.
Area of Science:
- Immunology
- Oncology
- Hematology
Background:
- Monocytic myeloid-derived suppressor cells (M-MDSCs) with a CD14+HLA-DRlow/- phenotype are crucial in tumor immunology.
- Their specific roles in acute myeloid leukemia (AML) remain less understood compared to solid tumors.
Purpose of the Study:
- To investigate the frequencies of M-MDSCs in AML patients.
- To determine the clinical significance of circulating M-MDSCs in AML prognosis, including diagnostic stratification, treatment response, and survival.
Main Methods:
- Flow cytometry was used to quantify M-MDSC frequencies (CD14+HLA-DRlow/-) in the peripheral blood of 109 newly diagnosed adult AML patients and 30 healthy controls.
- The study analyzed the association of M-MDSC levels with diagnostic stratification, induction therapy response, treatment maintenance, and long-term survival.
Main Results:
- AML patients exhibited significantly higher circulating M-MDSC frequencies in both CD14+ monocytes and PBMCs compared to healthy controls (p < 0.01).
- Elevated M-MDSCs correlated with lower complete remission rates, higher relapse/refractory rates, and poorer long-term survival in AML.
- No correlation was found between M-MDSC levels and common clinical or cytogenetic/molecular risk categories.
Conclusions:
- Circulating M-MDSCs are elevated in AML patients and are associated with unfavorable prognosis.
- M-MDSCs show potential as a valuable prognostic indicator for acute myeloid leukemia.
Background:
Monocytic myeloid-derived suppressor cells (M-MDSCs) characterized with the phenotype of CD14+HLA-DRlow/- have attracted a lot of attention in the field of human tumor immunology. However, little is known about the roles of M-MDSCs in acute myeloid leukemia (AML) as opposed to their multiple roles in solid tumors.
Methods:
We examined the frequencies of M-MDSCs identified for CD14+HLA-DRlow/- by flow cytometry in the peripheral circulating blood of 109 newly diagnosed adult patients with AML and 30 healthy controls (HC). Then, we, respectively, validated the clinic significance of circulating M-MDSCs on the relevance of spectral features for diagnostic stratification, induction therapy response, treatment effect maintenance, and long-term survival in AML.
Results:
Circulating M-MDSC frequencies of AML were significantly higher than those of HC both in CD14+ monocytes (46.22% ± 2.95% vs. 1.07% ± 0.17%, p < 0.01) and peripheral blood mononuclear cells (PBMCs) (4.21% ± 0.80% vs. 0.17% ± 0.03%, p < 0.01). Elevated circulating M-MDSCs in patients with AML were significantly associated with low complete remission (CR) rate, high relapse/refractory rate, and poor long-term survival, but had no correlation with common clinic risks and cytogenetic molecular risk categories.
Conclusions:
It was demonstrated that circulating M-MDSCs are elevated and associated with poor prognosis in AML, suggesting M-MDSCs might be a prognostic indicator for AML.
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