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  • 1.
    Kreutzman, Anna
    et al.
    Univ Helsinki, Hematol Res Unit Helsinki, Haartmaninkatu 8, FIN-00290 Helsinki, Finland;Helsinki Univ Hosp, Dept Hematol, Comprehens Canc Ctr, Haartmaninkatu 8, FIN-00290 Helsinki, Finland;Univ Helsinki, Dept Clin Chem, Helsinki, Finland.
    Yadav, Bhagwan
    Univ Helsinki, Hematol Res Unit Helsinki, Haartmaninkatu 8, FIN-00290 Helsinki, Finland;Helsinki Univ Hosp, Dept Hematol, Comprehens Canc Ctr, Haartmaninkatu 8, FIN-00290 Helsinki, Finland;Univ Helsinki, Dept Clin Chem, Helsinki, Finland.
    Brummendorf, Tim H.
    Univ Klinikum RWTH Aachen, Dept Hematol & Oncol, Aachen, Germany.
    Gjertsen, Bjorn Tore
    Univ Bergen, Haukeland Univ Hosp, Dept Internal Med, Hematol Sect, Bergen, Norway;Univ Bergen, Dept Clin Sci, Bergen, Norway.
    Hee, Moon Lee
    Univ Helsinki, Hematol Res Unit Helsinki, Haartmaninkatu 8, FIN-00290 Helsinki, Finland;Helsinki Univ Hosp, Dept Hematol, Comprehens Canc Ctr, Haartmaninkatu 8, FIN-00290 Helsinki, Finland;Univ Helsinki, Dept Clin Chem, Helsinki, Finland.
    Janssen, Jeroen
    Vrije Univ Amsterdam Med Ctr, Dept Hematol, Amsterdam, Netherlands.
    Kasanen, Tiina
    Univ Helsinki, Hematol Res Unit Helsinki, Haartmaninkatu 8, FIN-00290 Helsinki, Finland;Helsinki Univ Hosp, Dept Hematol, Comprehens Canc Ctr, Haartmaninkatu 8, FIN-00290 Helsinki, Finland.
    Koskenvesa, Perttu
    Univ Helsinki, Hematol Res Unit Helsinki, Haartmaninkatu 8, FIN-00290 Helsinki, Finland;Helsinki Univ Hosp, Dept Hematol, Comprehens Canc Ctr, Haartmaninkatu 8, FIN-00290 Helsinki, Finland.
    Lofti, Kourosh
    Linkoping Univ, Cty Council Ostergotland, Dept Med & Hlth Sci, Dept Hematol, Linkoping, Sweden.
    Markevarn, Berit
    Umea Univ Hosp, Dept Hematol, Umea, Sweden.
    Stromberg, Ulla Ohlsson
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology.
    Stentoft, Jesper
    Aarhus Univ Hosp, Dept Hematol, Aarhus, Denmark.
    Stenke, Leif
    Karolinska Univ Hosp, Dept Hematol, Stockholm, Sweden;Karolinska Inst, Stockholm, Sweden.
    Söderlund, Stina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
    Udby, Lene
    Zealand Univ Hosp, Dept Hematol, Roskilde, Denmark.
    Richter, Johan
    Skane Univ Hosp, Dept Hematol, Lund, Sweden.
    Hjorth-Hansen, Henrik
    St Olavs Hosp, Dept Hematol, Trondheim, Norway;Norwegian Univ Sci & Technol NTNU, Dept Clin & Mol Med IKOM, Trondheim, Norway.
    Mustjoki, Satu
    Univ Helsinki, Hematol Res Unit Helsinki, Haartmaninkatu 8, FIN-00290 Helsinki, Finland;Helsinki Univ Hosp, Dept Hematol, Comprehens Canc Ctr, Haartmaninkatu 8, FIN-00290 Helsinki, Finland;Univ Helsinki, Dept Clin Chem, Helsinki, Finland.
    Immunological monitoring of newly diagnosed CML patients treated with bosutinib or imatinib first-line2019In: Oncoimmunology, ISSN 2162-4011, E-ISSN 2162-402X, Vol. 8, no 9Article in journal (Refereed)
    Abstract [en]

    Changes in the immune system induced by tyrosine kinase inhibitors (TKI) have been shown to positively correlate with therapy responses in chronic myeloid leukemia (CML). However, only a few longitudinal studies exist and no randomized comparisons between two TKIs have been reported. Therefore, we prospectively analyzed the immune system of newly diagnosed CML patients treated with imatinib (n = 20) or bosutinib (n = 13), that participated in the randomized BFORE trial (NCT02130557). Comprehensive immunophenotyping, plasma protein profiling, and functional assays to determine activation levels of T and NK cells were performed at diagnosis, 3, and 12 months after therapy start. All results were correlated with clinical parameters such as Sokal risk and BCR-ABL load measured according to IS%. At diagnosis, low Sokal risk CML patients had a higher frequency of cytotoxic cells (CD8 + T and NK cells), increased cytotoxic potential of NK cells and lower frequency of naive and central memory CD4 + T cells. Further, soluble plasma protein profile divided patients into two distinct clusters with different disease burden at diagnosis. During treatment, BCR-ABL IS% correlated with immunological parameters such as plasma proteins, together with different memory subsets of CD4+ and CD8 + T cells. Interestingly, the proportion and cytotoxic potential of NK cells together with several soluble proteins increased during imatinib treatment. In contrast, no major immunological changes were observed during bosutinib treatment. In conclusion, imatinib and bosutinib were shown to have differential effects on the immune system in this randomized clinical trial. Increased number and function of NK cells were especially observed during imatinib therapy.

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