Katie Maurer, MD, PhD, from Dana-Farber Cancer Institute, shared #ASH24 findings suggesting that diverse bone marrow cell composition may predict treatment response in the content of AML patients undergoing HSCT.
I am a physician scientist who studies the biology of stem cell transplantation, um, primarily in patients who are receiving transplants from a donor who is not themselves um for treatment of leukemia. And what's really fascinating about this procedure is that we know that the donor immune system plays a role in keeping those patients in remission in the long term, but we don't know how. And we have some really exciting preliminary data um that pinpointed a specific CD8 T cell population with um cytotoxic activity that was associated with long-term survival in patients undergoing transplant for relapsed acute myeloid leukemia or AML. And so what we did for this abstract um is we wanted to understand how these cell populations were interacting with each other in space, in the bone marrow microenvironment. And so we took uh sections of bone marrow biopsy samples and we did um both protein and spatial transcriptomic profiling on these samples to try to understand what are the immune cell populations that are present in the bone marrow among responders to treatment and non-responders and how are they interacting. And we found a couple of really interesting observations. One is that in patients who respond, we have a really high proportion of T cells after treatment, which fits nicely with our um uh preliminary data, which was done on bone marrow aspirates. Um, and not only that, we see really high immunologic diversity among responders. And uh as opposed to non-responders who really have low immunologic diversity in their samples. And so what that really suggests to us is that the bone marrow microenvironment, um, really plays a large role in determining whether or not patients are going to respond to um the graft versus leukemia effect uh in the setting of bone marrow transplantation. Um, and this opens a lot of really exciting doors for us, um, to better understand in the future how these immune cells are working together, what specific cell types are important in mediating response, what specific molecules are important in mediating response, and how can we fine tune all of these features to try to make more patients respond and decrease relapse risk.
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