Identification of Predictive Biomarkers Based on Cytokine Profiles for Molecular Relapse After Treatment-Free Remission in Chronic Myeloid Leukemia Patients
Year: 2026
Type: article
Study design: Observational Study
Abstract: Tyrosine kinase inhibitors (TKIs) have transformed chronic myeloid leukemia (CML) into a manageable disease, and discontinuation has become a feasible goal for many patients. However, molecular relapse after TKI cessation remains a challenge. This study investigated factors influencing molecular relapse-free survival (MRFS) in a real-world cohort of CML patients undergoing TKI discontinuation, focusing on clinical, molecular, and immune-related variables. Traditional prognostic tools, such as the Sokal score, showed limited capacity to predict relapse risk in this context. Instead, total treatment duration and depth of molecular response emerged as critical predictors, with longer therapy and deeper remission associated with improved outcomes. A key novel finding was the prognostic relevance of cytokine profiles, particularly interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1). These cytokines were strong predictors of relapse in a decision tree model that achieved high specificity and positive predictive value in an independent validation cohort. Notably, lower IL-6 and MCP-1 levels were associated with increased relapse risk, suggesting reduced immune surveillance may contribute to recurrence. Integrating cytokine signatures with molecular markers improved prognostic accuracy, supporting immune biomarkers as complements to established clinical parameters. These findings underscore the complexity of relapse mechanisms and the need for individualized risk assessment when considering TKI discontinuation.
Source: Cells
Authors: Bianca Vasconcelos Cordoba, Carolina Pavlovsky, María Belén Sanchez, Elena Beatriz Moiraghi, Ana Ines Varela, Miguel Arturo Pavlovsky, Isabel Amanda Giere, Franco Federico Freilich, Isolda Fernandez, Maria José Mela Osório, Ricardo Khalil Tannuri, Federico Sackmann, Mariana Juni, Georgina Emilia Bendek Del Prete, Eduardo Oscar Bullorsky, Juan Dupont, Josefina Freitas, Verónica Ventriglia, Ana Garcia Labanca, Romina Mariano, Carina Gumpel, Etelvina Macchiavello, Pedro Negri Aranguren, Mariano Paoletti, Francisca Rojas, Maria Fernanda Tosin, Marta Catalan, Maria del Rosario Custidiano, Maria Cecilia Foncuberta, Julio Cesar Sánchez Ávalos, Silvia Miranda, José Mordoh, Estrella Mariel Levy, Michele Bianchini
Institutions: Fundación para la Investigación, Docencia y Prevención del Cáncer, Hospital Ramos Mejía, Hospital Italiano de Buenos Aires, Hospital Británico de Buenos Aires, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, Hospital Posadas, Hospital General de Agudos Dr. Enrique Tornú, Hospital de Clínicas "José de San Martín", Hospital El Cruce, Instituto Alexander Fleming
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,258
Award: G2775192149
OpenAlex ID: W7160143333