T-cell receptor anti-CMV CDR3s from bone marrow samples are associated with a worse overall survival for recurrent acute myeloid leukemia.

We assessed the relationship of AML patient outcomes and T-cell receptor (TCR) recombination reads representing known anti-viral TCR sequences. TCR complementary determining region-3's (CDR3s) were obtained from the pediatric TARGET-AML dataset, and the TCR CDR3s representing bone marrow samples of primary and recurrent disease were matched to anti-viral TCR CDR3s. The patients representing the presence of the anti-viral CDR3s were then assessed for overall survival (OS). Patients with anti-CMV TCR CDR3s from bone marrow samples representing recurrent AML showed a significant decrease in OS probability. Decreases in OS probabilities were also observed for patients with anti-Epstein Barr Virus (EBV) TCR CDR3s obtained from recurrent AML, bone marrow samples. Overall, this study raises the question of whether there is a relationship between viral infections, or the basic impact of anti-viral inflammation, and outcomes in pediatric AML?