In patients with juvenile myelomonocytic leukemia (JMML), 5-azacitidine has been utilized before stem cell transplantation. Researchers recently revealed immunophenotypic characteristics in JMML upon diagnosis. For a study, they sought to determine how immunophenotypic characteristics changed after azacitidine treatment and how that correlated with clinical response. Patients using 5-azacitidine were assessed at the time of diagnosis as well as after three and six cycles of treatment. After three cycles, 28 patients were checked, and after six cycles, 25 patients were assessed. Patients’ CD34/CD117+ cells decreased by 3.35% at diagnosis, 2.8% after three cycles, and 1.63% after six cycles. B-cell progenitors were reduced at the time of diagnosis and after therapy. Monocytes fell from 11.91% to 6.4% to 4.18%. 

An increase in classical monocytes was linked with a complete response. T cells, which were low at the time of diagnosis, rose in patients who responded to 5-azacitidine. Immunophenotypic abnormalities, including CD7 expression in myeloid progenitors, persisted following therapy. The trait was linked to a worse response to therapy as well as the existence of NF1. In all cases, immunophenotyping was possible. Although phenotypic aberrations persisted, clinical improvement was related to a decrease in myeloid progenitors and monocytes and an increase in T cells. After three rounds, the greatest benefit was noticed.

Reference:onlinelibrary.wiley.com/doi/10.1111/bjh.18089