Response to azacitidine and the TIM-3 inhibitor, sabatolimab, in MDS and CMML is associated with distinct immune and antigen-presentation states

This preprint profiles bone marrow and blood from patients with myelodysplastic syndrome and chronic myelomonocytic leukaemia treated with azacitidine plus sabatolimab, and reports that baseline HLA class II expression across haematopoietic progenitors, together with distinct CD8 T-cell and interferon-response programmes, is associated with response. Claidex holds one HAVCR2 failure, sabatolimab-havcr2-tim3-lower-risk-mds-phase2-strategic-termination, covering the same antibody in lower-risk myelodysplastic syndrome and terminated by strategic reprioritisation rather than on an efficacy readout. The preprint is close to a direct response-biomarker hypothesis for a programme that stopped without one. If baseline antigen-presentation state separates responders from non-responders, an unenriched population would dilute an effect that exists in a subgroup. Severity is MILD by rule on a single prior failure whose archetype is not efficacy, though the shared drug and disease make this the most actionable signal in this pass.