Unravelling a clinical role of peripheral blood leukemia stem cells at diagnosis in chronic myeloid leukemia patients: Final results of prospective FLOWERS study
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The authors previously demonstrated that in peripheral blood (PB) of chronic myeloid leukemia (CML), patients' leukemia stem cells (LSCs) CD26+ are detectable by flow cytometry at diagnosis, during tyrosine kinase inhibitor (TKI) therapy, and during treatment-free remission. METHODS: This study presents results of a prospective multicenter study including 242 newly diagnosed CML patients monitored for PB CD26+ leukemic stem cells (LSCs) quantification from diagnosis up to 24 months of TKI treatment. RESULTS: The bulk of CD26+ LSCs at diagnosis varied between patients with a median value of 7.14 cells/µL. During TKI treatment, it has been observed their consistent and rapid reduction without statistical differences according to type of first-line TKI. Instead, a significant correlation between a low amount of CD26+ LSCs at diagnosis and an optimal molecular response at 3, 12, and 24 months was documented (p = .03, p = .004, and p = .009, respectively). Three tertiles of CD26+ LSCs correlating to molecular response were identified: <3.21 cells/µL; between 3.21 and 19.21 cells/µL; and >19.21 cells/µL. The incidence of patients with optimal response was higher in the first CD26+ LSCs tertile respect to the third one (p = .027, p = .015, and p = .079, respectively) at all time points (3, 12 and 24 months). CONCLUSIONS: This study demonstrated a correlation between the amount of CD26+ LSCs at diagnosis and the molecular response, suggesting that the number of CD26+ LSCs at diagnosis could represent an additional tool for predicting TKI response.
Source: Cancer
DOI: 10.1002/cncr.70122
Authors: Anna Sicuranza, Paola Pacelli, Adele Santoni, Elisabetta Abruzzese, Daniele Cattaneo, Alessandra Iurlo, Luigiana Luciano, Sara Galimberti, Valentina Giai, Olga Mulas, Giovanni Caocci, Federica Sorà, Isabella Capodanno, Monica Crugnola, Antonella Gozzini, Sabina Russo, Mario Annunziata, Claudio Fozza, Alessandra Cartocci, Sara Fredducci, Emanuele Pacini, Anna Marina Liberati, Marzia Defina, Elena Bestoso, Cristina Marzano, Dania Tocci, Teresa Miracapillo, Camilla Turriziani, Katia Peccia, Donatella Raspadori, Monica Bocchia
Institutions: University of Siena, Azienda Ospedaliera Universitaria Senese, University of Rome Tor Vergata, St. Eugenio Hospital, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Federico II University Hospital, University of Naples Federico II, University of Pisa, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, University of Cagliari, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, Azienda Sanitaria Unità Locale di Reggio Emilia, Azienda Ospedaliero-Universitaria Careggi, University of Florence, University of Messina, Ospedale Antonio Cardarelli, University of Sassari, University of Perugia
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,790
Awards: G1832990945, G5591186319
OpenAlex ID: W4415199606