Advances in Cancer Immunotherapy and Stem Cell Research

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DOI :10.26650/B/LS17LS30.2025.038.005   IUP :10.26650/B/LS17LS30.2025.038.005    Tam Metin (PDF)

The Immunosuppressive Bone Marrow Microenvironment in Pediatric B-Cell Acute Lymphoblastic Leukemia

İlhan Tahralı, Günnur Deniz

Acute lymphoblastic leukemia (ALL), a hematological malignant disease of abnormal lymphoid precursor cells with uncontrolled proliferation in bone marrow, is the most common childhood cancer. B-ALL, generating from B lymphoid progenitor cells, is the most common form of the disease. Although the survival rate is high in patients treated with chemotherapeutic agents, side effects and drug resistance might occur. Thus, immunotherapy is gaining importance as a treatment option. Due to their importance in anti-cancer immunity, studies on natural killer (NK) cells in immunotherapy have increased. However, the efficiency of this treatment is lower than expected, which may be due to the immunosuppressive microenvironment in bone marrow of B-ALL patients. There are some evidences for the immunosuppressive microenvironment within the bone marrow of leukemia patients. In our recent study, bone marrow plasmas of pediatric B-ALL patients were cultured with peripheral blood mononuclear cells of healthy donors to investigate the effects of humoral components in bone marrow on NK cell functions. Conditions with fetal bovine serum and bone marrow plasmas of patients without leukemia were used as control groups. Plasma cytokine levels of both patient groups were also measured. In the conditions with B-ALL plasmas, PD-1 and intracellular IL-10 levels were found to be increased, while the proliferative capacities of NK cells were decreased compared to the control groups. High IL-10 versus low IL-18 and IFN-𝛾 levels were also detected in B-ALL bone marrow plasmas. These findings indicate that humoral components in the bone marrow microenvironment of B-ALL patients exert a suppressive effect on NK cells. 


Anahtar Kelimeler: Bone marrow microenvironment, acute lymphoblastic leukemia, immunotherapy

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