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Peripheral blood quantitation of CD26 positive leukemic stem cells as a predictor of tyrosine kinase inhibitor response in chronic myeloid leukemia

  • 0Department of Hematology, SGPGIMS, Lucknow, India.
International Journal of Laboratory Hematology +

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May 7, 2024

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May 7, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

A high count of leukemic stem cells (LSCs) in chronic myeloid leukemia (CML) patients at diagnosis predicts poor response to treatment. Specifically, fewer than 165 LSCs/μL in peripheral blood indicates a higher likelihood of achieving major molecular response (MMR).

Area Of Science

  • Hematology
  • Oncology
  • Stem Cell Biology

Background

  • Leukemic stem cells (LSCs) are transcriptionally silent and resistant to tyrosine kinase inhibitors.
  • LSCs play a critical role in disease relapse in chronic myeloid leukemia (CML).
  • Understanding LSC behavior is crucial for predicting treatment outcomes in CML.

Purpose Of The Study

  • To evaluate the correlation between absolute CML-LSC count in peripheral blood (PB) at diagnosis.
  • To assess the achievement of major molecular response (MMR) at 12 months in CML-CP patients treated with Imatinib.

Main Methods

  • Prospective, observational study of newly diagnosed adult CML-CP patients.
  • Absolute CD26+ CML-LSC quantification using multiparametric flow cytometry.
  • Monitoring BCR::ABL transcript levels at 3-month intervals; MMR defined as BCR::ABL1 <0.1% IS.

Main Results

  • 40.5% of patients achieved MMR at 12 months.
  • A significant difference in median absolute CML-LSC count between MMR achievers (58.5 cells/μL) and non-achievers (368.1 cells/μL) (p<0.001).
  • ROC analysis identified <165.69 CML LSC/μL as predictive of MMR with 83.8% sensitivity and 72.4% specificity.

Conclusions

  • Absolute CML-LSC count at diagnosis in PB is a predictor of MMR achievement at 12 months.
  • An absolute count <165 cells/μL strongly predicts MMR achievement within 12 months.
  • This finding aids in stratifying CML patients for treatment response.

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