Study on the impact of CD4⁺ T cells and their subsets on relapse in AML patients during remission

Area of Science:

• Immunology
• Hematology
• Oncology

Background:

• Minimal residual disease (MRD) is a key predictor of relapse in acute myeloid leukemia (AML).
• The role of immune cell function, particularly T lymphocytes, in AML relapse and MRD status remains incompletely understood.

Purpose of the Study:

• To investigate the relationship between T lymphocyte subpopulations, minimal residual disease (MRD), and relapse in acute myeloid leukemia (AML).
• To explore the functional impact of CD4+ T cells on leukemia cell behavior and cytokine production in the context of MRD.

Main Methods:

• Prospective study of 49 AML patients categorized by MRD status and relapse.
• Analysis of peripheral blood T lymphocyte subpopulations using ten-color flow cytometry.
• In vitro co-culture of CD4+ T cells with leukemia cell lines to assess proliferation, apoptosis, and cytokine release.

Main Results:

• MRD-positive relapsed AML patients showed significantly higher CD4+ T cells, regulatory T (Treg) cells, and naive T cells compared to non-relapsed patients.
• MRD-negative relapsed AML patients exhibited a significantly lower percentage of Treg cells.
• CD4+ T cells promoted leukemia cell proliferation, reduced apoptosis, and increased IL-10 expression.

Conclusions:

• CD4+ T cell-derived IL-10 may regulate the immune microenvironment in AML.
• Immune dysregulation involving CD4+ T cells could contribute to MRD persistence and disease recurrence in AML patients.