Study provides new insights into the immune response in leukemia

Acute myeloid leukemia (AML) is a rapidly progressing cancer of the blood cells and the most common type of acute leukemia in adults. In Finland, 300–400 new cases of AML are diagnosed annually. In AML, immature blood cells multiply rapidly in the bone marrow, blocking the production of healthy blood cells. 

Researchers examined the responses of various immune cells to an experimental immunotherapy in patients with AML and investigated the changes associated with the treatment response. Immunotherapies are cancer treatments that boost the body’s own immune system and help destroy cancer cells. 

“Cancer immunotherapies have revolutionized the treatment of several cancers in recent years. However, immunotherapies have not been as successful in the treatment of AML as they have been in treating other cancers,” says Jani Huuhtanen, MD, specializing physician in clinical hematology. 

The study was based on an early-phase clinical trial that enrolled patients at HUS Comprehensive Cancer Center. The patients received sabatolimab immunotherapy targeting the TIM-3 molecule in combination with decitabine, which is part of the established treatment for patients with AML. The researchers analyzed blood and bone marrow samples from the patients to investigate how the various immune cell types reacted to the therapy. 

Immune response in leukemia differed from expectations 

The effectiveness of immunotherapy is in many cancers based on the activation of killer T cells. In AML patients, however, such changes were observed only to a limited extent. This can partly explain why therapies based on the same mechanisms have not been as successful in treating leukemia as they have been for other cancers. 

“The surprising discovery was that the significant changes in patients that benefited from the treatment weren’t primarily in killer T cells, but in the natural killer, or NK, cells and helper T cells. This observation suggests that, in leukemia, other immune cells may have a key role in the immune defense against cancer,” says Satu Mustjoki, professor of translational hematology and specialist in clinical chemistry. 

The study helps explain why immunotherapies work differently for different cancers. At the same time, it identifies new areas for research that could support the development of more precisely targeted immunotherapies in the future. 

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