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Peer-reviewedCC BY 4.0Cancers

Monitoring of (Potentially Leukemia-Specific) Immune Cells After AML Relapse Post-Transplantation Across Treatment Groups and Disease Stages

  • Philipp Anand1,2,3
  • Julian Stein1,2,3
  • Joudi Abdulmajid1,2,3
  • Xiaojia Feng1,2,3
  • Christian Wichmann4
  • Linping Chen-Wichmann4
  • Christoph Schmid2,5
  • Helga Maria Schmetzer1,2,3
  • Giuliano Filippini Velazquez2,5
5 affiliations
  1. 1Dep., Med. III, University Hospital of Munich, 81377 Munich, Germany
  2. 2Bavarian Cancer Research Center (BZKF), 91054 Erlangen, Germany
  3. 3Workgroup: Immunomodulation, Department of Medicine III, University Hospital Munich, Marchioninistraße 15, 81377 Munich, Germany
  4. 4Department for Transfusion Medicine, Cell Therapeutics and Haemostaseology, University Hospital, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
  5. 5Department of Haematology and Oncology, University Hospital of Augsburg, 86156 Augsburg, Germany
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Abstract

Purpose: Relapse after allogeneic stem cell transplantation (SCT) in acute myeloid leukemia (AML) remains a major therapeutic challenge. This study longitudinally assessed immune responses in relapsed AML patients post-SCT under different therapeutic regimens, focusing on (potentially) leukemia-specific cytotoxicity and survival outcomes. Methods: The composition and profile of peripheral immune cells of 14 AML patients in hematological relapse post-SCT were evaluated by flow cytometry. Patients were stratified by clinical stage and treatment: relapse without therapy (Rw/o), relapse under/after HMA ± VCLX (RHMAs/VCLX), relapse under/after Kit-M treatment (RKit-M), and complete or partial remission after treatment (PR/CR). Frequencies of blasts, dendritic cells, (potentially) leukemia-specific IFNγ-producing or CD107a-degranulating T/NK/CIK cells, and immune checkpoint marker expression (PD-1, CTLA-4, TIM-3, TIGIT, KLRG1) were quantified. Immune profiles were also compared between long-term survivors (‘alive’) and ‘deceased’ patients. Results: Increased immune activation, characterized by increased frequencies of (potentially) leukemia-derived dendritic cells, enhanced frequencies of CD107a+/IFNγ+ effector and memory T/NK cells and reduced frequencies of cells expressing inhibitory checkpoint markers observed in the RHMAs/VCLX group (and even more in a single anecdotal patient, treated with Kit M RKit-M). Patients in remission after treatment (PR/CR) exhibited stabilization of these immune effects, indicating restored immune surveillance. Long-term survivors exhibited higher frequencies of functional CD107a+ T and IFNγ+ NK/CIK cells, while the ‘deceased’ group displayed signs of increased immune exhaustion and diminished effector responses. Conclusions: HMA/VCLX therapy (and Kit-M treatment) induced measurable, potentially) (leukemia-specific) immune responses in relapsed AML patients post-SCT. Elevated functional immune subsets correlated with long-term survival, underscoring their role as potential prognostic biomarkers. Despite a very heterogeneous patient cohort and treatment, our findings support immune monitoring post-SCT to improve risk stratification and highlight the therapeutic potential of immune-modulating treatments in relapsed AML.

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Cite

BibTeXRIS
BibTeX
@article{anand2026monitoring,
  title = {{Monitoring of (Potentially Leukemia-Specific) Immune Cells After AML Relapse Post-Transplantation Across Treatment Groups and Disease Stages}},
  author = {Philipp Anand and Julian Stein and Joudi Abdulmajid and Xiaojia Feng and Christian Wichmann and Linping Chen-Wichmann and Christoph Schmid and Helga Maria Schmetzer and Giuliano Filippini Velazquez},
  journal = {Cancers},
  year = {2026},
  month = oct,
  doi = {10.3390/cancers18213421},
  url = {https://www.mdpi.com/2072-6694/18/21/3421},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Monitoring of (Potentially Leukemia-Specific) Immune Cells After AML Relapse Post-Transplantation Across Treatment Groups and Disease Stages
AU  - Philipp Anand
AU  - Julian Stein
AU  - Joudi Abdulmajid
AU  - Xiaojia Feng
AU  - Christian Wichmann
AU  - Linping Chen-Wichmann
AU  - Christoph Schmid
AU  - Helga Maria Schmetzer
AU  - Giuliano Filippini Velazquez
PY  - 2026
DA  - 2026/10/22
JO  - Cancers
DO  - 10.3390/cancers18213421
UR  - https://www.mdpi.com/2072-6694/18/21/3421
AB  - Purpose: Relapse after allogeneic stem cell transplantation (SCT) in acute myeloid leukemia (AML) remains a major therapeutic challenge. This study longitudinally assessed immune responses in relapsed AML patients post-SCT under different therapeutic regimens, focusing on (potentially) leukemia-specific cytotoxicity and survival outcomes. Methods: The composition and profile of peripheral immune cells of 14 AML patients in hematological relapse post-SCT were evaluated by flow cytometry. Patients were stratified by clinical stage and treatment: relapse without therapy (Rw/o), relapse under/after HMA ± VCLX (RHMAs/VCLX), relapse under/after Kit-M treatment (RKit-M), and complete or partial remission after treatment (PR/CR). Frequencies of blasts, dendritic cells, (potentially) leukemia-specific IFNγ-producing or CD107a-degranulating T/NK/CIK cells, and immune checkpoint marker expression (PD-1, CTLA-4, TIM-3, TIGIT, KLRG1) were quantified. Immune profiles were also compared between long-term survivors (‘alive’) and ‘deceased’ patients. Results: Increased immune activation, characterized by increased frequencies of (potentially) leukemia-derived dendritic cells, enhanced frequencies of CD107a+/IFNγ+ effector and memory T/NK cells and reduced frequencies of cells expressing inhibitory checkpoint markers observed in the RHMAs/VCLX group (and even more in a single anecdotal patient, treated with Kit M RKit-M). Patients in remission after treatment (PR/CR) exhibited stabilization of these immune effects, indicating restored immune surveillance. Long-term survivors exhibited higher frequencies of functional CD107a+ T and IFNγ+ NK/CIK cells, while the ‘deceased’ group displayed signs of increased immune exhaustion and diminished effector responses. Conclusions: HMA/VCLX therapy (and Kit-M treatment) induced measurable, potentially) (leukemia-specific) immune responses in relapsed AML patients post-SCT. Elevated functional immune subsets correlated with long-term survival, underscoring their role as potential prognostic biomarkers. Despite a very heterogeneous patient cohort and treatment, our findings support immune monitoring post-SCT to improve risk stratification and highlight the therapeutic potential of immune-modulating treatments in relapsed AML.
SN  - 2072-6694
ER  -