The acute myeloid leukemia microenvironment impairs neutrophil maturation and function through NF-κB signaling

P Paran Goel (1University of Alabama, Birmingham, Birmingham, United States) S Sajesan Aryal (1University of Alabama at Birmingham, Birmingham, United States) A Alana M. Franceski (1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL) V Valeriya Kuznetsova (2The University of Alabama at Birmingham, Birmingham, United States) A Amanda Costa (1University of Alabama, Birmingham, Birmingham, United States) F Francesca Luca (Department of Clinical and Biological Science, University of Torino) A Ashley N. Connelly (1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL) D Daniel W. Phillips (1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL) C Caroline C. Ennis (1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL) B Brittany M. Curtiss (1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL) S Sourajeet Karfa (1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL) B Brittany L. Crown (1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL) C Christina R. Larson (1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL) E Estelle Carminita (1Boston Children's Hospital, Vascular Biology Program, Boston, United States) V Virginia Camacho (1Boston Children's Hospital, Vascular Biology Program, Boston, United States) D Doug Welsch (1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL) C Changde Cheng (1University of Alabama, Birmingham, Birmingham, United States) A Asumi Yokota (5Laboratory of Stem Cell Regulation, School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan) I Isidoro Cobo (University of Alabama at Birmingham, Birmingham, Alabama, United States) H Hideyo Hirai (Tokyo University of Pharmacy and Life Sciences) R Rui Lu R Ravi Bhatia (1University of Alabama at Birmingham, Birmingham, United States) P Pran K. Datta (1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL) P P. Brent Ferrell (7Department of Medicine, Vanderbilt University Medical Center, Nashville, TN) R Robert S. Welner

Abstract

Abstract Acute myeloid leukemia (AML), an aggressive hematological malignancy, is driven by oncogenic mutations in stem and progenitor cells that give rise to AML blasts. Although these mutations are well characterized, their impact on healthy hematopoiesis, those blood cells exposed to AML but not mutated, has not been well characterized. Because the marrow is the major site for granulopoiesis, neutrophils are heavily influenced by AML pathobiology. Indeed, most patients with AML report neutropenia, rendering them susceptible to infections. However, because AML studies use peripheral blood mononuclear cells devoid of neutrophils, the characterization of neutrophil dysfunction remains poorly understood. To investigate AML-exposed neutrophils, a preclinical AML mouse model in which primary leukemic cells were transplanted into nonirradiated neutrophil reporter (Ly6G-tdTomato; Catchup) hosts was used. Neutrophils could not completely mature, suggesting impaired granulopoiesis. Single-cell transcriptomics of AML-exposed neutrophils revealed higher inflammation signatures and expression of CD14, an inflammatory marker. To address the factors contributing to this biology, an ex vivo cytokine screen was performed on marrow neutrophils, and it identified that nuclear factor κB signaling drove CD14 expression. AML-exposed neutrophils displayed widespread chromatin remodeling, and de novo motif discovery predicted increased binding sites for CCAAT enhancer–binding proteins and interferon regulatory factors. Moreover, AML-exposed neutrophils inhibited T-cell proliferation, highlighting their immune-suppressive capability. Finally, a similar biology of immature, inflammatory neutrophils was found in patients with AML, again indicating dysregulated granulopoiesis. Collectively, these data show that AML-associated inflammation alters neutrophil granulopoiesis, impairs neutrophil function, and drives immunosuppression, thereby contributing to patient susceptibility to infection.

Article Details

Journal Blood
Volume / Issue Vol. 146, Issue 14
Published October 02, 2025
Pages 1707-1721
ISSN 0006-4971
Publisher Elsevier BV

Journal Info

Blood

Elsevier BV

ISSN: 0006-4971 Health Sciences

Authors (25)

P

Paran Goel

1University of Alabama, Birmingham, Birmingham, United States

S

Sajesan Aryal

1University of Alabama at Birmingham, Birmingham, United States

A

Alana M. Franceski

1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL

V

Valeriya Kuznetsova

2The University of Alabama at Birmingham, Birmingham, United States

A

Amanda Costa

1University of Alabama, Birmingham, Birmingham, United States

F

Francesca Luca

Department of Clinical and Biological Science, University of Torino

A

Ashley N. Connelly

1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL

D

Daniel W. Phillips

1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL

C

Caroline C. Ennis

1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL

B

Brittany M. Curtiss

1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL

S

Sourajeet Karfa

1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL

B

Brittany L. Crown

1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL

C

Christina R. Larson

1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL

E

Estelle Carminita

1Boston Children's Hospital, Vascular Biology Program, Boston, United States

V

Virginia Camacho

1Boston Children's Hospital, Vascular Biology Program, Boston, United States

D

Doug Welsch

1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL

C

Changde Cheng

1University of Alabama, Birmingham, Birmingham, United States

A

Asumi Yokota

5Laboratory of Stem Cell Regulation, School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan

I

Isidoro Cobo

University of Alabama at Birmingham, Birmingham, Alabama, United States

H

Hideyo Hirai

Tokyo University of Pharmacy and Life Sciences

R

Rui Lu

R

Ravi Bhatia

1University of Alabama at Birmingham, Birmingham, United States

P

Pran K. Datta

1Division of Hematology and Oncology, Department of Medicine, O'Neal Comprehensive Cancer Center at The University of Alabama at Birmingham, Birmingham, AL

P

P. Brent Ferrell

7Department of Medicine, Vanderbilt University Medical Center, Nashville, TN

R

Robert S. Welner