Clinical Implications of Aberrant PD-1 Expression for Acute Leukemia Prognosis

Abstract

Background: Acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) are the most common types of leukemia in adults with an overall poor prognosis. PD-1 alone or combined with other immune checkpoint blockade is a promising research direction for the treatment of acute leukemia (AL) patients. However, clinical Implications of aberrant PD-1 expression in peripheral CD4+ and CD8+ T lymphocytes of AML and ALL patients in assessing the prognosis of diseases, remains inconclusive. Methods: In the present study, we used flow cytometry to evaluate PD-1 expression on the surface of CD4+ and CD8+ T lymphocytes in the peripheral circulation of AML and ALL patients and its clinical significance. A total of 53 AML patients, 44 ALL patients and 28 healthy controls were enrolled in this study and peripheral blood specimens were detected by flow cytometry. Results: Our results indicated that percentages of CD4+PD1+ and CD8+PD1+ T lymphocytes in newly diagnosed and non-remission groups were significantly higher than healthy control both in AML and ALL patients. The high level of CD4+PD1+ and CD8+PD1+ T lymphocyteswere respectively poor prognostic indicators of AML patients and ALL patients but had no significant correlation with most common clinical risks. Conclusions: Our findings show that aberrant PD-1 expression correlates with the prognosis of AL patient and may thus serve as poor prognostic indicators. Immunotherapy using PD-1 inhibitors may be a promising strategy for AML and ALL patients with peripheral circulating CD4+PD1+ and CD8+PD1+ T lymphocytes positively expressed, respectively.

The Role of Immune Check Point Gene Expression of Pd-1 and Tim-3 in Patients with Acute Myeloid Leukemia

“…(P<0.0001) as shown in Figure 2. This result corresponds with Ruan who observed that the expression of PD1 was increased significantly and the levels of PD1 in AML (p<0.0001), and AML (p<0.0001) were obviously higher than those in controls [18]. The high expression of PD-1 the activates of PD-1/PD-L1 signaling pathway continuously and inhibits the various signaling pathways [16] [17].…”