Deep learning-based cell segmentation identifies T cell infiltration and spatial distribution in de novo pediatric AML

Emerging evidence suggests that the presence of immune cells in the tumor microenvironment (TME) may be predictive of the response to immunotherapy. Accordingly, we characterized the infiltration and spatial distribution of T cells in diagnostic bone biopsies of 22 children with de novo acute myeloid leukemia (AML). Archival biopsies were acquired through the Dutch Pathology Registry (PALGA; 2021-82). Subsequently, immunohistochemistry was performed using antibodies directed against CD3 in combination with hematoxylin. We identified low to intermediate T cell infiltration among most biopsies (mean 9.5% (SD = 13.0) of total cells or 843 cells/mm2 (SD = 1212). In contrast, we did identify two biopsies that were heavily infiltrated with T cells, and which showed localized clustering of T cells. T cell infiltration was not related to the number of blasts in the bone marrow (median 34%, range 0–98). In conclusion, most pediatric AML patients have poor T cell infiltration in the TME at diagnosis, indicating that (combinations of) immune priming therapies may be required for successful implementation of immunotherapies in pediatric AML.

Publication History

Article published online:
17 May 2022