Killer immunoglobulin-like receptor genotypes and chronic myeloid leukemia outcomes after imatinib cessation for treatment-free remission

Cancer Med. 2019 Sep;8(11):4976-4985. doi: 10.1002/cam4.2371. Epub 2019 Jul 9.

Abstract

Background: Natural Killer (NK) cells are innate lymphoid cells that can be cytotoxic toward a large panel of solid tumors and hematological malignancies including chronic myeloid leukemia (CML). Such a cytotoxicity depends on various receptors. Killer immunoglobulin-like receptors (KIR) belong to these receptors and are involved in maturation process, then in the activation abilities of NK cells.

Methods: We investigated the prognostic impact of the KIR2DL5B genotype in 240 CML patients included in two clinical trials investigating tyrosine kinase inhibitors (TKI) discontinuation: STIM and STIM2.

Results: After adjustment for standard risk factors in CML, we found that the inhibitory receptor KIR2DL5B-positive genotype was independently related to a delayed second deep molecular remission (HR 0.54, 95% CI [0.32-0.91], P = 0.02) after TKI rechallenge but not to time to first deep molecular remission or treatment-free remission rates.

Conclusion: These results suggest that KIR2DL5B could carry a role in lymphocyte-mediated control of leukemic residual disease control in patient with CML relapse.

Keywords: chronic myeloid leukemia; imatinib; killer immunoglobulin-like receptors; natural killer; treatment-free remission.

MeSH terms

  • Aged
  • Antineoplastic Agents / therapeutic use
  • Biomarkers
  • Female
  • Genetic Variation*
  • Genotype*
  • Haplotypes
  • Humans
  • Imatinib Mesylate / therapeutic use
  • Immunophenotyping
  • Killer Cells, Natural / drug effects
  • Killer Cells, Natural / metabolism
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics*
  • Male
  • Middle Aged
  • Protein Kinase Inhibitors / therapeutic use
  • Receptors, KIR / genetics*
  • Receptors, KIR / metabolism
  • Receptors, KIR2DL5 / genetics
  • Remission Induction
  • Treatment Outcome
  • Withholding Treatment

Substances

  • Antineoplastic Agents
  • Biomarkers
  • KIR2DL5B protein, human
  • Protein Kinase Inhibitors
  • Receptors, KIR
  • Receptors, KIR2DL5
  • Imatinib Mesylate