Myeloid-derived suppressor cells (MDSCs) are thought to help provide a cellular microenvironments in many solid tumors, in which transformed cells proliferate, acquire new mutations, and evade host immunosurveillance. In the present study, we found that MDSCs (CD33 + CD11b + HLA-DRlow/neg) in bone marrow were significantly increased in adult acute myeloid leukemia (AML) patients. MDSCs levels in newly diagnosed AML patients correlated well with extramedullary infiltration and plasma D-dimer levels. Remission rates in the MDSCs > 1500 group and MDSCs < 1500 group were 72.73 and 81.25 %, respectively. No significant differences were found between the two groups. MDSC levels in the complete remission group were significantly decreased after chemotherapy, while in the partial remission and non-remission groups, there were no significant differences. The level of MDSCs in the high minimal residual disease (MRD) group was significantly higher than that in the middle and low MRD groups. High levels of Wilms’ Tumor-1 (WT-1) protein were strongly correlated with higher bone marrow MDSC levels. In conclusion, we report here a population of immunosuppressive monocytes in the bone marrow of patients with AML characterized by the CD33highCD11b + HLA-DRlow/neg phenotype. These cells appear to impact the clinical course and prognosis of AML. This data may provide potentially important targets for novel therapies.
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This study was supported by grants from the National Natural Science Foundation of China (No. 81200575 and No. 81000731), the Promotive Research Fund for Excellent Young and Middle-Aged Scientists of Shandong Province (No. BS2012YY025) and the Shandong Provincial Key Clinical specialist construction projects (Lu Wei Yi  26).
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Conflict of interest
The authors declare that they have no conflict of interest.
Ries LAG, Melbert D, Krapcho M, Stinchcomb DG, Howlader N, Horner MJ et al. SEER Cancer Statistics Review. 1975–2005. National Cancer Institute. Bethesda, MD. http://seer.cancer.gov/csr/1975_2005/. Accessed 23 May 2015
Yu J, Du W, Yan F, Wang Y, Li H, Cao S, et al. Myeloid-derived suppressor cells suppress antitumor immune responses through IDO expression and correlate with lymph node metastasis in patients with breast cancer. J Immunol. 2013;190:3783–97.CrossRefPubMedGoogle Scholar
Poschke I, Mougiakakos D, Hansson J, Masucci GV, Kiessling R. Immature immunosuppressive CD14 + HLA-DR-/low cells in melanoma patients are Stat3hi and overexpress CD80, CD83, and DC-sign. Cancer Res. 2010;70:4335–45.CrossRefPubMedGoogle Scholar
Filipazzi P, Huber V, Rivoltini L. Phenotype, function and clinical implications of myeloid-derived suppressor cells in cancer patients. Cancer Immunol Immunother. 2012;61:255–63.CrossRefPubMedGoogle Scholar
Gorgun GT, Whitehill G, Anderson JL, Hideshima T, Maguire C, Laubach J, et al. Tumor-promoting immune-suppressive myeloid-derived suppressor cells in the multiple myeloma microenvironment in humans. Blood. 2013;121:2975–87.PubMedCentralCrossRefPubMedGoogle Scholar
Liu J, Zhou Y, Huang Q, Qiu L. CD14HLA-DR expression: a novel prognostic factor in chronic lymphocytic leukemia. Oncol Lett. 2015;9:1167–72.PubMedCentralPubMedGoogle Scholar
Zhang ZN, Shen T. Diagnosis and curative effect standard of blood disease. 3rd ed. Beijing: Science Press; 2007. p. 116–21.Google Scholar
Ochoa AC, Zea AH, Hernandez C, Rodriguez PC. Arginase, prostaglandins, and myeloid-derived suppressor cells in renal cell carcinoma. Clin Cancer Res. 2007;13:721s–6s.CrossRefPubMedGoogle Scholar
Almand B, Clark JI, Nikitina E, van Beynen J, English NR, Knight SC, et al. Increased production of immature myeloid cells in cancer patients: a mechanism of immunosuppression in cancer. J Immunol. 2001;166:678–89.CrossRefPubMedGoogle Scholar
Ramachandran IR, Martner A, Pisklakova A, Condamine T, Chase T, Vogl T, et al. Myeloid-derived suppressor cells regulate growth of multiple myeloma by inhibiting T cells in bone marrow. J Immunol. 2013;190:3815–23.PubMedCentralCrossRefPubMedGoogle Scholar
Jitschin R, Braun M, Buttner M, Dettmer-Wilde K, Bricks J, Berger J, et al. CLL-cells induce IDOhi CD14 + HLA-DRlo myeloid-derived suppressor cells that inhibit T-cell responses and promote TRegs. Blood. 2014;124:750–60.CrossRefPubMedGoogle Scholar
Lin Y, Gustafson MP, Bulur PA, Gastineau DA, Witzig TE, Dietz AB. Immunosuppressive CD14 + HLA-DR(low)/− monocytes in B-cell non-Hodgkin lymphoma. Blood. 2011;117:872–81.PubMedCentralCrossRefPubMedGoogle Scholar
Wei X, Xu YD, HE J. Clinical significance of plasma D-dimer measurement in acute leukemia patients. J China Med Univ. 2011;V40:343.Google Scholar
Gustafson MP, Abraham RS, Lin Y, Wu W, Gastineau DA, Zent CS, et al. Association of an increased frequency of CD14 + HLA-DR lo/neg monocytes with decreased time to progression in chronic lymphocytic leukaemia (CLL). Br J Haematol. 2012;156:674–6.PubMedCentralCrossRefPubMedGoogle Scholar
Fricke I, Mirza N, Dupont J, Lockhart C, Jackson A, Lee JH, et al. Vascular endothelial growth factor-trap overcomes defects in dendritic cell differentiation but does not improve antigen-specific immune responses. Clin Cancer Res. 2007;13:4840–8.CrossRefPubMedGoogle Scholar
Kusmartsev S, Eruslanov E, Kubler H, Tseng T, Sakai Y, Su Z et al. Oxidative stress regulates expression of VEGFR1 in myeloid cells: link to tumor-induced immune suppression in renal cell carcinoma. J Immunol. 2008;181:346–53.CrossRefPubMedGoogle Scholar
Diaz-Montero CM, Salem ML, Nishimura MI, Garrett-Mayer E, Cole DJ, Montero AJ. Increased circulating myeloid-derived suppressor cells correlate with clinical cancer stage, metastatic tumor burden, and doxorubicin-cyclophosphamide chemotherapy. Cancer Immunol Immunother. 2009;58:49–59.PubMedCentralCrossRefPubMedGoogle Scholar