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Type: Journal article
Title: Reduced CD62L expression on T cells and increased soluble CD62L levels predict molecular response to tyrosine kinase inhibitor therapy in early chronic-phase chronic myelogenous leukemia
Author: Sopper, S.
Mustjoki, S.
White, D.
Hughes, T.
Valent, P.
Burchert, A.
Gjertsen, B.
Gastl, G.
Baldauf, M.
Trajanoski, Z.
Giles, F.
Hochhaus, A.
Ernst, T.
Schenk, T.
Janssen, J.
Ossenkoppele, G.
Porkka, K.
Wolf, D.
Citation: Journal of Clinical Oncology, 2017; 35(2):175-184
Publisher: American Society of Clinical Oncology
Issue Date: 2017
ISSN: 1527-7755
Statement of
Sieghart Sopper, Satu Mustjoki, Deborah White, Timothy Hughes, Peter Valent, Andreas Burchert, Bjørn T. Gjertsen, Günther Gastl, Matthias Baldauf, Zlatko Trajanoski, Frank Giles, Andreas Hochhaus, Thomas Ernst, Thomas Schenk, Jeroen J.W.M. Janssen, Gert J. Ossenkoppele, Kimmo Porkka, and Dominik Wolf
Abstract: PURPOSE Immunologic surveillance of minimal residual disease in chronic myelogenous leukemia (CML) may be relevant for long-term control or cure of CML. Little is known about immune-modulatory effects of nilotinib in vivo, potentially predicting response to therapy. PATIENTS AND METHODS A prospective and comprehensive flow cytometry–based immunomonitoring program paralleled the ENEST1st clinical study, investigating 52 nilotinib-naïve patients with chronic-phase CML. Data were verified in independent validation cohorts. RESULTS T cells of patients with CML at diagnosis expressed low l-selectin (CD62L) levels, which was not a result of proportional aberrations of T-cell subsets. Low numbers of CD62L-expressing CD4+ and CD8+ T cells correlated with higher Sokal score, increased spleen size, and high leukocyte and peripheral-blood blast counts. At month 6 during nilotinib therapy, CD62L expression returned to levels of healthy individuals. The level of CD62L loss on T cells directly correlated with the extent of soluble CD62L (sCD62L) elevation. In parallel, the proteolytic activity of tumor necrosis factor α–converting enzyme (TACE; ADAM17, CD156b), the metalloproteinase shedding CD62L, was increased at diagnosis and significantly decreased during nilotinib treatment. High CD62L+ expression on both CD4+ and CD8+ T cells and, vice versa, low sCD62L levels at CML diagnosis were linked to superior molecular responses. These findings were corroborated in independent validation cohorts. CONCLUSION We demonstrate the prognostic impact of CD62L shedding from T cells and increased sCD62L plasma levels at CML diagnosis on molecular response to tyrosine kinase inhibitor therapy in early chronic-phase CML. Functionally, decreased CD62L may be a consequence of increased TACE-mediated CD62L cleavage and potentially impairs immune-cell function. Larger prospective studies are ongoing to confirm the prognostic relevance of this finding.
Keywords: T-Lymphocytes
Antineoplastic Agents
Immunologic Factors
Protein Kinase Inhibitors
Flow Cytometry
Prospective Studies
Immunologic Surveillance
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
ADAM17 Protein
Rights: © 2016 by American Society of Clinical Oncology
DOI: 10.1200/JCO.2016.67.0893
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