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. 2020 Feb 25;11:147. doi: 10.3389/fimmu.2020.00147

Figure 2.

Figure 2

Tumor-Extrinsic Mechanisms of Immune Evasion and Relapse. This cartoon summarizes several of the pathways exploited by leukemic cells in order to rewire the bone marrow microenvironment and evade immune recognition. In particular, featured in the figure are the deregulated release by AML blasts of cytokines, such as interferon-γ (IFN-γ), interleukin-15 (IL-15), and granulocyte-colony stimulating factor (G-CSF); the expression of enzymes involved in aminoacid metabolism, such as arginase (Arg) and indoleamine 2,3-dioxygenase (IDO-1); and the upregulation of the ectonucleotidases CD73 and CD39 that leads to the increase in extracellular adenosine (ADO). All of these mediators can have an impact on the frequency and function of immune cell subsets, impairing T and NK cell activity, driving effector T cells toward exhaustion, inducing the expansion of regulatory T cells (Treg), and promoting the phenotypic switch of macrophages from pro-inflammatory M1 to immuno-suppressive M2.