Bone marrow plasma cytokine composition indicates acute myeloid leukemia progression and treatment response

The progression of acute myeloid leukemia (AML) is characterized by intricate interactions between leukemia cells and the bone marrow (BM) microenvironment.

In this study, we conducted a comprehensive analysis of the plasma cytokine composition in BM samples from patients with AML. A total of 75 BM samples were collected from AML patients consecutively recruited, including 41 newly diagnosed (ND-AML), 19 complete remission (CR) and 15 relapsed/refractory cases (R/R-AML). Using enzyme-linked immunoadsorbent assay, we analyzed BM plasma levels of interleukin (IL)-1 family (IL-1β, IL-1RA and IL-18), IL-2 family (IL-2, IL-4, IL-13, IL-15 and IL-21), IL-12, interferon-gamma (IFN-γ), innate inflammatory and immune regulatory cytokines [IL-6, IL-10, IL-17, tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)-β].

Our study found significant differences in BM plasma inflammatory and immunologic cytokines between ND-AML, CR, and R/R-AML, with notable changes in LDH, ELN risk, IL-12, IL-18, and IL-21 between incomplete remission (ICR) and CR status. These cytokines were at weakened level in the BM microenvironment of R/R-AML. Concentrations of IL-17 and TGF-β in BM plasma elevated at initial diagnosis, declined after CR, and increased again at relapse, indicating the disease activity.

These findings emphasize the dynamic monitoring of BM plasma cytokines during AML progression, and highlight the significance of cytokine composition in guiding treatment and improving patient outcomes.