Principal component analysis uncovers cytomegalovirus-associated NK cell activation in Ph+ leukemia patients treated with dasatinib

• Published in: Leukemia 2017, Vol.31 (1), p.203-212
• Main Authors: Ishiyama, K-i, Kitawaki, T, Sugimoto, N, Sozu, T, Anzai, N, Okada, M, Nohgawa, M, Hatanaka, K, Arima, N, Ishikawa, T, Tabata, S, Onaka, T, Oka, S, Nakabo, Y, Amakawa, R, Matsui, M, Moriguchi, T, Takaori-Kondo, A, Kadowaki, N
• Format: Article
• Language: English
• Subjects: 13; 13/31; 631/67/1990/2331; 631/67/580/1884; Cancer Research; Care and treatment; Cell activation; Cell differentiation; Critical Care Medicine; Cytomegalovirus; Cytomegalovirus infections; Dasatinib; Dasatinib - therapeutic use; Development and progression; Etiology; Exploitation; Genetic aspects; Health aspects; Hematology; Hospitals; Humans; Immune response regulation; Intensive; Internal Medicine; Killer cells; Killer Cells, Natural - immunology; Killer Cells, Natural - microbiology; Kinases; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - immunology; Lymphocytes; Lymphocytosis; Medicine; Medicine & Public Health; Natural killer cells; Oncology; original-article; Patient outcomes; Patients; Philadelphia-positive myeloid leukemia; Physiological aspects; Principal Component Analysis; Principal components analysis; Rheumatology; Virus Activation
• ISSN: 0887-6924; 1476-5551
• DOI: 10.1038/leu.2016.174

Dasatinib treatment markedly increases the number of large granular lymphocytes (LGLs) in a proportion of Ph + leukemia patients, which associates with a better prognosis. The lymphocytosis is predominantly observed in cytomegalovirus (CMV)-seropositive patients, yet detectable CMV reactivation exists only in a small fraction of patients. Thus, etiology of the lymphocytosis still remains unclear. Here, we identified NK cells as the dominant LGLs expanding in dasatinib-treated patients, and applied principal component analysis (PCA) to an extensive panel of NK cell markers to explore underlying factors in NK cell activation. PCA displayed phenotypic divergence of NK cells that reflects CMV-associated differentiation and genetic differences, and the divergence was markedly augmented in CMV-seropositive dasatinib-treated patients. Notably, the CMV-associated highly differentiated status of NK cells was already observed at leukemia diagnosis, and was further enhanced after starting dasatinib in virtually all CMV-seropositive patients. Thus, the extensive characterization of NK cells by PCA strongly suggests that CMV is an essential factor in the NK cell activation, which progresses stepwise during leukemia and subsequent dasatinib treatment most likely by subclinical CMV reactivation. This study provides a rationale for the exploitation of CMV-associated NK cell activation for treatment of leukemias.