Relapse, Leukemia, Interferon discussed on NEJM This Week - Audio Summaries
The investigators performed a comprehensive analysis of samples from patients who had a relapse of acute myeloid leukemia AM L after he a poetic stem cell transplantation to define the genetic. And epi genetic alterations that allow leukemia cells to escape the graft versus leukemia effect and to determine whether the dysregulation of known immune related genes is a common feature of relapse after transplantation on Exon sequencing the spectrum of gained and lost mutations. Observed with relapse after transplantation was similar to the spectrum observed with relapse after chemotherapy, specifically relapse after transplantation was not associated with the acquisition of previously unknown AML specific mutations or structural variations in immune related, gene. Enes. In contrast, RNA sequencing of samples obtained at relapse after transplantation reveal dysregulation of pathways involved in adaptive and innate, immunity, including down regulation of major histocompatibility complex m h c class to genes to levels that were three to twelve times lower than the level seen impaired samples obtained at presentation flow Saitama tree and immuno history. Chemical analysis confirmed decreased expression of m h c class to at relapse in seventeen of thirty four patients who had relapsed after transplantation evidence suggested that interferon gamma treatment could rapidly reverse this pheno type enamel blasts in vitro. Overall survival with value MAB after chemo radiotherapy in stage..