Modulation of Leukemic Blasts into Dendritic Cells (DC_leu) and Their Role in Predicting Survival in Patients with AML...

Acute myeloid leukemia (AML) is characterized by impaired anti-leukemic immune responses, and the ex vivo or in vivo generation of dendritic cells (DCs), including leukemic dendritic cells (DC_leu), represents a promising strategy to stimulate immune cells and improve anti-leukemic activity.

This study examined the generation, phenotype and functional relevance of DCs and DC_leu produced ex vivo from blast-containing PBMNCs and whole blood (WB) in AML. Using both standard DC/DC_leu-generating protocols and available Kits.

We show that DC/DC_leu can be reliably generated with both methods. Generated DC/DC_leu effectively activated T cells during mixed lymphocyte cultures (MLCs), resulting in enhanced anti-leukemic cytotoxicity. Improved blast lysis correlated with specific immunological features, including higher frequencies of generated DC_leu and mature DC subsets, as well as a certain cytokine pattern after DC/DC_leu cultures or MLC. In addition, the frequencies of proliferating T cells after MLC strongly correlated with the degree of achieved blast lysis, underscoring the importance of efficient DC/DC_leu-mediated T cell stimulation. Both the frequencies of generated DC/DC_leu and the resulting blast lytic activity were linked to overall survival (OS) in AML patients. Individuals who failed to demonstrate improved blast lysis exhibited significantly reduced OS, suggesting inadequate immune responsiveness of patients in vivo.

These findings identify phenotypic and functional immune parameters as predictors of clinical outcome and highlight the prognostic relevance of ex vivo immune profiling. This approach may help to optimize and personalize future immunotherapeutic strategies in AML.