f BM-infiltrating OX40 + cytotoxic cells and helper T lymphocytes; (iii) highly immunosuppressive regulatory T cells, such as ICOS high /PD-1 − and myeloid-derived suppressor cells (PD-1 low ) are expanded in BM of TP53 -mutant patients; (iv) a higher proportion of ICOS high /PD-1 − Treg cells is a highly significant independent predictor of overall survival. 261 According to these observations it was concluded that TP53 -mutant MDS/AMLs have an immunosuppressive and immunoevasive environment that favor their development and resistance to therapy and that immunomodulatory therapeutic strategies may provide some benefit.
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