Identification of peripheral blood CD26+ leukemic stem cells has a potential role in the rapid diagnosis of chronic myeloid leukemia

Abstract

Chronic myeloid leukemia (CML) is a hematopoietic stem cell (SC) neoplasm characterized by the presence of BCR-ABL1 fusion, which results in constitutive activation of tyrosine kinase (TK) domain leading to proliferation and expansion of immature and mature myeloid cells. The laboratory diagnosis of CML depends on the demonstration of t(9;22)(BCR-ABL1) by cytogenetic techniques, fluorescence in situ hybridization (FISH), or appropriate molecular techniques such as reverse transcriptase-polymerase chain reaction (RTPCR). 1 Therapeutic intervention with TK inhibitors (TKI) like imatinib, dasatinib, etc., is effective in controlling the disease leading to undetectable levels of BCR-ABL1 and clinical remission in the majority of the patients but are not curative. 2 The CML leukemic stem

Flow Cytometric Assessment of CD26-Positive Leukemic Stem Cells: A Rapid and Valuable Tool in the Diagnosis and Follow-Up of Chronic Myeloid Leukemia

“…The follow-up testing with flow cytometry showed a reduced CD26 count with a median absolute count of 0.7 cells/μL with a range of 0 to 15.36. Similar results were reported by Bocchia et al and Sharma et al [ 8 , 13 ].…”

“…Although only 10 non-CML patients were studied as controls, CD26 was not detected in any of them. The majority of the earlier studies have reported CD26 to be consistently negative in non-CML cases [ 11 - 13 ]. This shows the specificity of the CD26 marker to correctly identify the cases with CML.…”

“…There have been two published literature from India on CD26 and CML. Both these studies were published in 2022 and were from Northern India [ 11 , 13 ]. Sharma et al studied 64 patients with CML with a median CD26 percentage of 0.07 with a range of 0.002 to 1.3.…”

“…Sharma et al studied 64 patients with CML with a median CD26 percentage of 0.07 with a range of 0.002 to 1.3. All 15 patients who were followed up had detectable amounts of CD26-positive LSCs with a median of 0.003% ranging from zero to 26.79 [ 13 ]. Rahman et al enumerated CD26-positive LSCs from CML patients irrespective of their phase of the disease.…”

The Bone Marrow Immune Microenvironment in CML: Treatment Responses, Treatment-Free Remission, and Therapeutic Vulnerabilities

“…In contrast, interim analyses of the PROSPECTIVE FLOWERS study revealed that PB BCR::ABL1 + measurement was not associated with CD26 + LSC levels after initiation of TKI therapy, although CD26 + LSC levels at diagnosis could predict subsequent responses to TKIs [37]. The correlation of CD26 + LSC numbers in the PB and BM [38] may reflect their disrupted BM-homing ability, but also support its utility as a predictive biomarker.…”