[HTML][HTML] Enlarged memory T-cell pool and enhanced Th1-type responses in chronic myeloid leukemia patients who have successfully discontinued IFN-α …

M Ilander, A Kreutzman, P Rohon, T Melo, E Faber… - PLoS …, 2014 - journals.plos.org
M Ilander, A Kreutzman, P Rohon, T Melo, E Faber, K Porkka, J Vakkila, S Mustjoki
PLoS One, 2014journals.plos.org
A small proportion of chronic myeloid leukemia patients treated with interferon-α (IFN-α)
monotherapy are able to discontinue the treatment without disease relapse although
residual leukemia cells are present. Recently, we showed that these patients have
increased amount of NK-cells and a distinct blood cytokine profile. We now aimed to study
the function of NK-and T-cells in order to understand the role of the immune system in
maintaining the treatment response after IFN-α discontinuation. The study included 13 …
A small proportion of chronic myeloid leukemia patients treated with interferon-α (IFN-α) monotherapy are able to discontinue the treatment without disease relapse although residual leukemia cells are present. Recently, we showed that these patients have increased amount of NK-cells and a distinct blood cytokine profile. We now aimed to study the function of NK- and T-cells in order to understand the role of the immune system in maintaining the treatment response after IFN-α discontinuation. The study included 13 patients: 5 patients were still treated with IFN-α monotherapy (IFN-ON, median treatment time 163 months) and 8 had stopped the treatment successfully (IFN-OFF, median time without therapy 42 months). Detailed immunophenotype and cytokine production of NK- and T-cells was analyzed with flow cytometry. In addition, the cytotoxicity of NK-cells was studied using K562 as target cells and both the degranulation and direct killing was measured. Compared to healthy controls, IFN-OFF patients had increased proportion of CD4+ effector memory (CCR7CD45RA; median 23% vs. healthy 16%, p = 0.009) and CD8+ central memory T-cells (CCR7+CD45RA; median 26% vs. healthy 14%, p = 0.004). Further, upon stimulation the IFN-γ/TNF-α cytokine secretion by CD4+ T-cells was significantly enhanced in IFN-OFF patients (median 13.7% vs. healthy 7.8%, p = 0.01), and CD4+ effector and central memory cells were the main cytokine producers. No similar increase was observed in IFN-ON group (6.5%). In addition, the proportion of NK-cells was significantly increased in IFN-OFF patients (median IFN-OFF 24%, healthy 13%, p = 0.04), but their direct killing of K562 cells was impaired. The cytotoxicity of NK-cells was also diminished in IFN-ON patients. To conclude, in addition to elevated NK-cell count, IFN-OFF patients have increased amount of memory T-cells, which are able to induce strong cytokine response upon stimulation. This activity may contribute to the maintenance of prolonged remission after successful IFN-α discontinuation.
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