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- Title
Tyrosine kinase inhibitor therapy-induced changes in humoral immunity in patients with chronic myeloid leukemia.
- Authors
Rajala, Hanna; Missiry, Mohamed; Ruusila, Anniina; Koskenvesa, Perttu; Brümmendorf, Tim; Gjertsen, Bjorn; Janssen, Jeroen; Lotfi, Kourosh; Markevärn, Berit; Olsson-Strömberg, Ulla; Stenke, Leif; Stentoft, Jesper; Richter, Johan; Hjorth-Hansen, Henrik; Kreutzman, Anna; Mustjoki, Satu
- Abstract
Purpose: Tyrosine kinase inhibitors (TKIs) have well-characterized immunomodulatory effects on T and NK cells, but the effects on the humoral immunity are less well known. In this project, we studied TKI-induced changes in B cell-mediated immunity. Methods: We collected peripheral blood (PB) and bone marrow (BM) samples from chronic myeloid leukemia (CML) patients before and during first-line imatinib ( n = 20), dasatinib ( n = 16), nilotinib ( n = 8), and bosutinib ( n = 12) treatment. Plasma immunoglobulin levels were measured, and different B cell populations in PB and BM were analyzed with flow cytometry. Results: Imatinib treatment decreased plasma IgA and IgG levels, while dasatinib reduced IgM levels. At diagnosis, the proportion of patients with IgA, IgG, and IgM levels below the lower limit of normal (LLN) was 0, 11, and 6% of all CML patients, respectively, whereas at 12 months timepoint the proportions were 6% ( p = 0.13), 31% ( p = 0.042) and 28% ( p = 0.0078). Lower initial Ig levels predisposed to the development of hypogammaglobulinemia during TKI therapy. Decreased Ig levels in imatinib-treated patients were associated with higher percentages of immature BM B cells. The patients, who had low Ig levels during the TKI therapy, had significantly more frequent minor infections during the follow-up compared with the patients with normal Ig values (33% vs. 3%, p = 0.0016). No severe infections were reported, except recurrent upper respiratory tract infections in one imatinib-treated patient, who developed severe hypogammaglobulinemia. Conclusions: TKI treatment decreases plasma Ig levels, which should be measured in patients with recurrent infections.
- Subjects
TREATMENT of chronic myeloid leukemia; PROTEIN-tyrosine kinase inhibitors; HUMORAL immunity; IMMUNOLOGICAL adjuvants; CANCER immunology
- Publication
Journal of Cancer Research & Clinical Oncology, 2017, Vol 143, Issue 8, p1543
- ISSN
0171-5216
- Publication type
Article
- DOI
10.1007/s00432-017-2378-6