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Updated: May 1, 2026
Immunoglobulin Gene Sequence Analysis In Chronic Lymphocytic Leukemia: From Patient Material To Sequence Interpretation
Published on: November 26, 2018
High class II-associated invariant chain peptide expression on residual leukemic cells is associated with increased
Willemijn van den Ancker1, Marvin M van Luijn1, Martine E D Chamuleau1
1Department of Hematology, Cancer Center Amsterdam, VU Institute for Cancer and Immunology, VU University Medical Center, Amsterdam, The Netherlands.
Insights
Class II-associated invariant chain (CLIP) on acute myeloid leukemia (AML) cells predicts poor outcomes. CLIP expression on minimal residual disease (MRD) cells indicates a higher risk of relapse, even at low levels.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Class II-associated invariant chain (CLIP) is present on leukemic cells.
- CLIP is associated with immune escape in leukemic cells.
- CLIP may impair the immunogenicity of minimal residual disease (MRD) cells.
Purpose of the Study:
- To investigate the association between CLIP expression on leukemia-associated phenotype (LAP)-positive cells and clinical outcome in acute myeloid leukemia (AML).
- To determine if CLIP expression can predict relapse in AML patients, particularly those with low MRD levels.
Main Methods:
- Analysis of CLIP expression on LAP-positive cells in AML patients during follow-up.
- Correlation of CLIP expression levels with relapse-free survival.
- Evaluation of CLIP's predictive value for AML relapse.
Main Results:
- CLIP expression on LAP-positive cells significantly correlates with shortened relapse-free survival.
- This correlation holds even in patients with low levels of MRD (0.01-0.1% LAP(+) cells).
- CLIP evaluation can provide additional value in MRD assessment for predicting AML relapse.
Conclusions:
- CLIP expression on MRD cells is a negative prognostic marker in AML.
- CLIP evaluation can enhance the prediction of relapse in AML patients.
- Targeting CLIP may offer therapeutic strategies to improve AML outcomes.
Abstract:
The presence of class II-associated invariant chain (CLIP) on leukemic cells is negatively associated with clinical outcome in untreated acute myeloid leukemia (AML). CLIP plays a role in the immune escape of leukemic cells, suggesting that it impairs the immunogenicity of minimal residual disease (MRD) cells causing a relapse. Here, we demonstrate that CLIP expression on leukemia-associated phenotype (LAP)-positive cells during follow-up is significantly correlated with a shortened relapse-free survival, even in those patients who are generally considered as MRD(low) (0.01-0.1% LAP(+) cells). Consequently, CLIP evaluation could be of additional value in the evaluation of MRD to predict a relapse of AML.
