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Allogeneic stem cell transplantation (ASCT) is a curative therapy for poor-risk and relapsed acute myeloid leukemia, due in large part to the immunologic effects of graft-versus-leukemia (GVL).
Investigators performed a single-institution analysis via whole-exome and RNA sequencing of paired pre- and post-ASCT samples for 15 patients who relapsed following HLA-matched or mismatched transplantation.
No new gene mutations arose among the relapsed samples. However, RNA sequencing revealed a multifold decrease in major histocompatibility complex (MHC) gene expression that, in turn, contributed to immune escape from GVL.