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Mesothelin Expression in Acute Leukemia: Correlations With Immunophenotype, Cytogenetics, and Mutational Status
Dua'a N Ashour1, Manal A Abbas1, Maher A Sughayer2
1Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University.
Applied Immunohistochemistry & Molecular Morphology : AIMM
|February 2, 2026
Summary
Mesothelin is rare in acute lymphoblastic leukemia (ALL) but found in specific acute myeloid leukemia (AML) subtypes. This study found no link between mesothelin expression and survival outcomes in either leukemia type.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Mesothelin is an immunotherapy target overexpressed in solid tumors.
- Its role in acute lymphoblastic leukemia (ALL) is unclear, despite presence on acute myeloid leukemia (AML) blast cells.
Purpose of the Study:
- To evaluate mesothelin expression in newly diagnosed acute leukemia.
- To determine the association of mesothelin with leukemia subtypes and clinical outcomes.
Main Methods:
- Immunohistochemistry on bone marrow biopsies and ELISA on plasma samples were used.
- 181 newly diagnosed acute leukemia cases (AML and ALL) were analyzed.
Main Results:
- Mesothelin was expressed in 31% of pediatric and 15% of adult AML cases, but rare in ALL.
- Expression in AML correlated with CD38, CD64, KMT2A-rearranged, and core binding factor subtypes.
- No significant association was found between mesothelin and survival, remission, or relapse in AML or ALL.
- Soluble mesothelin was detected in a subset of adult AML and ALL cases.
Conclusions:
- Mesothelin is largely absent in ALL but present in specific AML subtypes.
- Mesothelin expression is not a prognostic marker for survival in acute leukemias.
- Further research may explore mesothelin's role in specific AML subsets.
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