AUTHOR=Kim Sang T. , Sheshadri Ajay , Shannon Vickie , Kontoyiannis Dimitrios P. , Kantarjian Hagop , Garcia-Manero Guillermo , Ravandi Farhad , Im Jin S. , Boddu Prajwal , Bashoura Lara , Balachandran Diwakar D. , Evans Scott E. , Faiz Saadia , Ruiz Vazquez Wilfredo , Divenko Margarita , Mathur Rohit , Tippen Samantha P. , Gumbs Curtis , Neelapu Sattva S. , Naing Aung , Wang Linghua , Diab Adi , Futreal Andrew , Nurieva Roza , Daver Naval TITLE=Distinct Immunophenotypes of T Cells in Bronchoalveolar Lavage Fluid From Leukemia Patients With Immune Checkpoint Inhibitors-Related Pulmonary Complications JOURNAL=Frontiers in Immunology VOLUME=11 YEAR=2021 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2020.590494 DOI=10.3389/fimmu.2020.590494 ISSN=1664-3224 ABSTRACT=

Patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) treated with immune checkpoint inhibitors (ICIs) are at risk of pneumonitis as well as pneumonia (combined henceforth as ICI-related pulmonary complications). Little is known about the cellular and molecular mechanisms underlying ICI-related pulmonary complications. We characterized lymphocytes from bronchoalveolar lavage (BAL) fluid and peripheral blood from seven AML/MDS patients with pulmonary symptoms after ICI-based therapy (ICI group) and four ICI-naïve AML/MDS patients with extracellular bacterial or fungal pneumonias (controls). BAL T cells in the ICI group were clonally expanded, and BAL IFNγ+ IL-17− CD8+ T and CXCR3+ CCR6+ Th17/Th1 cells were enriched in the ICI group. Our data suggest that these cells may play a critical role in the pathophysiology of ICI-related pulmonary complications. Understanding of these cell populations may also provide predictive and diagnostic biomarkers of ICI-related pulmonary complications, eventually enabling differentiation of pneumonitis from pneumonia in AML/MDS patients receiving ICI-based therapies.