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Prognostic value of CD25/CD123 pattern of expression in acute myeloid leukemia patients with normal cytogenetic
Salah Aref1,2, Emaad Azmy3, Lamiaa Ibrahim3
1Hematology Unit, Clinical Pathology Department, Mansoura University Oncology Center (MUOC), Mansoura University, Mansoura, Egypt.
Insights
High expression of interleukin-2 receptor (CD25) and interleukin-3 receptor (CD123) in cytogenetically normal acute myeloid leukemia (CN-AML) indicates a poor prognosis. This CD25+/CD123+ co-expression is linked to lower remission rates and shorter survival in CN-AML patients.
Area of Science:
- Hematology
- Oncology
- Molecular Biology
Background:
- Cytogenetically normal acute myeloid leukemia (CN-AML) represents a heterogeneous group.
- Accurate prognostic markers are crucial for risk stratification and treatment decisions in CN-AML.
Purpose of the Study:
- To evaluate the prognostic significance of interleukin-2 receptor (CD25) and interleukin-3 receptor (CD123) expression in CN-AML patients.
- To determine the association between CD25/CD123 co-expression and clinical outcomes, including remission rates and overall survival.
Main Methods:
- Flow cytometry was used to analyze CD25 and CD123 expression on blast cells in 80 newly diagnosed CN-AML patients.
- Expression levels were correlated with remission induction, overall survival, and common mutations like FLT3 and NPM1.
Main Results:
- CD25+/CD123+ co-expression was observed in 21.25% of patients.
- Patients with CD25+/CD123+ co-expression exhibited significantly lower remission rates (P<0.01) and shorter overall survival (P=0.023).
- CD25+/CD123+ co-expression strongly correlated with FLT3 mutations (P<0.001) and inversely with NPM1 mutations (P<0.001).
Conclusions:
- CD25+/CD123+ co-expression identifies a subgroup of CN-AML patients with an adverse prognosis.
- Assessing CD25 and CD123 expression at diagnosis can aid in refining risk stratification for CN-AML.
- The findings highlight the potential utility of CD25/CD123 as biomarkers in CN-AML management.
Abstract:
This study was designed to assess the significance of interleukin-2 receptor (CD25) and inteleukin-3 receptor (CD123) expression in cytogenetically normal acute myeloid leukemia (CN-AML) patients. The current study includes 80 CN-AML (≤ 60 years) before the start of therapy. Blast cells expression for CD25 and CD123 were identified by flowcytometry in fresh bone marrow samples. CD25+/CD123-; CD25-/CD123+. CD25+/CD123+, CD25-/CD123- expression were as follow: 10/80 (12.5%); 18/80 (22.5%); 17/80; (21.25%), 35/80 (43.5%) respectively. The total CD25 expression was detected in 27/80 (33.75%), and CD123 expression was detected in 35/80 (43.75%%). CN-AML patients showed CD25+/CD123+ co-expression had the lowest induction remission rate and the shortest overall survival as compared to those lack co-expressions (P <0.01; P = 0.023 respectively). Also, there is strong positive association between CD25+/CD123+ co-expression and FLT3 mutations (P<0.001) and negative one with NPM1 mutation (P<0.001). In conclusion: CD25+/CD123+ co-expression in CN-AML patients define a subgroup of patients with adverse outcome. Identification of CD25/CD123 expression in CN-AML patents at diagnosis could be included in risk stratification. There is strong association between CD25+/CD123+ positive expression and FLT3 mutations.
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