title: Circulating bcr-abl-specific CD8+ T cells in chronic myeloid leukemia patients and healthy subjects.
abstract: OBJECTIVE
  The fusion oncoprotein bcr-abl that characterizes chronic myeloid leukemia (CML) is a leukemia-specific antigen, which may be immunogenic in vivo. KQSSKALQR and GFKQSSKAL, peptide sequences spanning the b3a2 bcr-abl junction, have affinity for HLA-A3 and HLA-B8, respectively, and we have shown the presence of KQSSKALQR on the surface of CML cells. We analyzed the existence of bcr-abl-specific T cells in vivo and correlated their presence to contemporary disease burden.
  
  
  METHODS
  We investigated circulating CD8+ T lymphocytes directed against the bcr-abl junction, using fluorochrome-labeled tetramers of HLA-A3 with KQSSKALQR and of HLA-B8 with GFKQSSKAL, and flow cytometry analysis. Using chromium-release assays and interferon-g ELISPOT assays, we also studied the functionality of these expanded T cells.
  
  
  RESULTS
  Eight of 12 b3a2+ HLA-A3+ and/or HLA-B8+ CML patients studied serially on at least three occasions had bcr-abl junction-specific CD8+ T cells. Specific T cells were more likely to be found in patients with a low leukemic burden (p=0.03). Three of 18 HLA-A3+ and/or HLA-B8+ healthy donors had bcr-abl junction-specific T cells, though these were not detected in any of 13 subjects who were HLA-A3- and HLA-B8-. Bcr-abl-specific T cells were expandable in vitro in three of seven healthy donors and five of seven CML patients.
  
  
  CONCLUSIONS
  Bcr-abl-specific T cells are detectable in CML patients, and might contribute to leukemic control. The occurrence of specific CD8+ T cells in some healthy donors might represent an immune response to occult BCR-ABL rearrangements.
authors.affiliation: Department of Hematology, University of Liverpool, Prescot St., Liverpool L7 8XP, United Kingdom.
authors.forename: Nauman M
authors.initials: NM
authors.lastname: Butt
authors.forename: José M
authors.initials: JM
authors.lastname: Rojas
authors.forename: Lihui
authors.initials: L
authors.lastname: Wang
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Christmas
authors.forename: Hazem M
authors.initials: HM
authors.lastname: Abu-Eisha
authors.forename: Richard E
authors.initials: RE
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018414:CD8-Positive T-Lymphocytes / Q000737:chemistry / Q000378:metabolism*; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000097:blood*; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*
chemical_list: D016044:Fusion Proteins, bcr-abl