A new study published in the journal Nature Cancer has shed light on the link between inflammation and the development of acute myeloid leukemia (AML), a hematopoietic malignancy with poor prognosis and limited treatment options. The study, conducted by researchers at NYU Langone Health and its Perlmutter Cancer Center, found that severe inflammation weakens the body's ability to fight cancerous blood cells in patients with AML.

Using bone marrow samples from 20 adults and 22 children with AML, the researchers were able to score each patient's level of inflammation using a new "iScore" system. The iScores were then correlated to survival rates, with patients having the lowest iScores typically surviving the longest. Leukemic patients with high iScores died at least four years earlier than those with low levels of inflammation.

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The study provides a comprehensive census of the bone marrow immune microenvironment in adult and pediatric patients with AML. The researchers characterized unique inflammation signatures in a subset of AML patients associated with inferior outcomes.

They also identified atypical B cells, a dysfunctional B-cell subtype enriched in patients with high-inflammation AML, as well as an increase in CD8+GZMK+ and regulatory T cells, accompanied by a reduction in T-cell clonal expansion.

The iScore system can be used with existing tools to measure AML severity and help physicians and patients decide on the best treatment options. The measurements needed to calculate a patient's iScore are freely available in the study manuscript for academic researchers and clinicians.

The study also found that adding the iScore refines current risk stratifications for patients with AML and may enable identification of patients in need of more aggressive treatment. The researchers also provide a framework for classifying patients with AML based on their immune microenvironment and a rationale for consideration of the inflammatory state in clinical settings.

These findings provide a new understanding of the complex relationship between inflammation and the development of AML and could lead to more effective treatment options for patients with this life-threatening disease.