CD8+T cells are critical players in anti-tumor immunity against solid tumors, targeted by immunotherapies. Emerging evidence suggests that CD8+T cells also play a crucial role in anti-tumor responses and determining treatment outcomes in hematologic malignancies like myelodysplastic neoplasms (MDS) and acute myeloid leukemia (AML). In this review, we focus on the implication of CD8+T cells in the treatment response of patients with MDS and AML. First, we review reported studies of aberrant functionality and clonality of CD8+T cells in MDS and AML, often driven by the immunosuppressive bone marrow microenvironment, which can hinder effective antitumor immunity. Additionally, we discuss the potential use of CD8+T cell subpopulations, including memory and senescent-like subsets, as predictive biomarkers for treatment response to a variety of treatment regimens, such as hypomethylating agents, which is the standard of care for patients with higher-risk MDS, and chemotherapy which is the main treatment of patients with AML. Understanding the multifaceted role of CD8+T cells and their interaction with malignant cells in MDS and AML will provide useful insights into their potential as prognostic/predictive biomarkers, but also uncover alternative approaches to novel treatment strategies that could reshape the therapeutic landscape, thus improving treatment efficacy, aiding in overcoming treatment resistance and improving patient survival in these challenging myeloid neoplasms.
CD8+T细胞是实体瘤抗肿瘤免疫的关键效应细胞，也是免疫治疗的重要靶点。最新研究表明，在骨髓增生异常肿瘤（MDS）和急性髓系白血病（AML）等血液系统恶性肿瘤中，CD8+T细胞同样对抗肿瘤反应及治疗结局具有决定性作用。本综述聚焦CD8+T细胞在MDS和AML患者治疗反应中的临床意义。首先，我们系统回顾了MDS和AML中CD8+T细胞功能异常与克隆性改变的相关研究，指出这些异常常由免疫抑制性骨髓微环境驱动，可能阻碍有效的抗肿瘤免疫。此外，我们探讨了CD8+T细胞亚群（包括记忆性T细胞和衰老样T细胞亚群）作为治疗反应预测生物标志物的潜在价值，这些治疗方案包括高危MDS标准治疗药物去甲基化药物，以及AML主要治疗手段化疗。深入理解CD8+T细胞在MDS和AML中的多重作用及其与恶性细胞的相互作用，不仅能为预后/预测生物标志物的开发提供新思路，更有助于探索可重塑治疗格局的新型治疗策略，从而提高疗效、克服耐药性并改善这类难治性髓系肿瘤患者的生存预后。
The Emerging Role of CD8+T Cells in Shaping Treatment Outcomes of Patients with MDS and AML
肿瘤(癌症)患者之家