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Purpose <p>Chronic myeloid leukemia (CML) is effectively treated with tyrosine kinase inhibitors (TKIs), yet over 25% of patients develop resistance. Leukemic stem cells (LSCs) expressing CD26, have been implicated in disease persistence and treatment failure. This study aimed to evaluate the expression of CD26 + LSCs in Tunisian patients with CML in chronic phase (CP), to compare its levels between optimal and failure responders, and to correlate CD26 + expression with molecular response.</p> Methods <p>In this cross-sectional study, 48 CP CML patients undergoing TKI therapy were assessed. Peripheral blood samples were analyzed for CD26 expression on CD45+/CD34+/CD38 − stem cells using multiparametric flow cytometry. Concurrently, molecular response was evaluated by measuring BCR-ABL1 transcript levels via standardized RT-qPCR.</p> Results <p>CD26 + LSCs were detectable in 83% of patients. Their levels were significantly higher in failure responders (mean = 3.39/µL) compared to those with optimal response (mean = 0.61/µL; <i>p</i> = 0.003). A significant, albeit weak, correlation was observed between CD26 + LSCs and BCR-ABL1 ratio (Spearman <i>r</i> = 0.300, <i>p</i> &lt; 0.05). CD26 + LSCs were undetectable only in patients with sustained deep molecular response.</p> Conclusion <p>CD26 + LSCs can be a useful marker in follow up of patients with CML. Despite promising findings, the limited sample size highlight the need for larger, prospective studies to validate these results and assess the predictive value of CD26 + LSCs for TKI discontinuation strategies.</p>

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Assessment of CD26+ Leukemic Stem Cells in Tunisian Patients with Chronic Myeloid Leukemia in the Era of Tyrosine Kinase Inhibitor Therapy

  • 期刊论文

  • 发表日期：

    2025年8月6日

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  • Fatma Turki,
  • Nour Louati,
  • Yosra Fakhfekh,
  • Nasira Zribi,
  • Ikram Ben Amor,
  • Olfa Kassar,
  • Leila Keskes,
  • Hassen Kamoum,
  • Moez Elloumi,
  • Jalel Gargouri,
  • Rim Fikha

摘要

Purpose

Chronic myeloid leukemia (CML) is effectively treated with tyrosine kinase inhibitors (TKIs), yet over 25% of patients develop resistance. Leukemic stem cells (LSCs) expressing CD26, have been implicated in disease persistence and treatment failure. This study aimed to evaluate the expression of CD26 + LSCs in Tunisian patients with CML in chronic phase (CP), to compare its levels between optimal and failure responders, and to correlate CD26 + expression with molecular response.

Methods

In this cross-sectional study, 48 CP CML patients undergoing TKI therapy were assessed. Peripheral blood samples were analyzed for CD26 expression on CD45+/CD34+/CD38 − stem cells using multiparametric flow cytometry. Concurrently, molecular response was evaluated by measuring BCR-ABL1 transcript levels via standardized RT-qPCR.

Results

CD26 + LSCs were detectable in 83% of patients. Their levels were significantly higher in failure responders (mean = 3.39/µL) compared to those with optimal response (mean = 0.61/µL; p = 0.003). A significant, albeit weak, correlation was observed between CD26 + LSCs and BCR-ABL1 ratio (Spearman r = 0.300, p < 0.05). CD26 + LSCs were undetectable only in patients with sustained deep molecular response.

Conclusion

CD26 + LSCs can be a useful marker in follow up of patients with CML. Despite promising findings, the limited sample size highlight the need for larger, prospective studies to validate these results and assess the predictive value of CD26 + LSCs for TKI discontinuation strategies.