Assessment of soluble syndecan-1 level in adult patients with de novo acute myeloid leukemia and its correlation with hematological parameters and treatment response

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BACKGROUND: Syndecan-1 (CD138) is a member of the transmembrane proteoglycans family that is expressed in various normal and malignant tissues. It attracted the attention because of its possible prognostic role when expressed in different tumors as well as its role as a target for therapy by the monoclonal antibody indatuximab coupled with other cytotoxic agents. In acute myeloid leukemia (AML), syndecan-1 was found to be significantly increased either inside leukocytes or as a soluble form in the plasma and it was correlated with overall survival of AML patients and with more bleeding manifestations and impaired platelet function. AIMS: The aims of this study were to assess the level of soluble syndecan-1 (or CD 138) in adult patients with de novo AML compared to the control group and to explore any possible correlation between the level of syndecan-1 with hematological parameters and response to remission induction therapy. PATIENTS AND METHODS: Cross-sectional study recruited 60 newly diagnosed adult AML patients. Moreover, 25 healthy individuals were included as the control group. The peripheral blood and bone marrow smears were examined at presentation for establishing the diagnosis and after remission induction for assessing the treatment response. Plasma syndecan-1 assay was done by sandwich enzyme-linked immunosorbent assay, which was done to patients at time of diagnosis. RESULTS: Plasma syndecan-1 (SDC-1) level of AML patients at presentation was much higher than that in the control group (P < 0.001); there was also a statistically significant difference in plasma level of syndecan-1 between male and female patients (P = 0.002). There was no significant difference for plasma (SDC-1) level between different AML French American British (FAB) subtypes; however, the highest level was seen among patients with the M3 subtype. No significant difference for plasma (SDC-1) level was seen between the patients who achieved remission status and patients who failed to achieve remission after chemotherapy and also between patients alive and deceased after 6 months of follow-up. Insignificant correlations were demonstrated between soluble (SDC-1) and the presenting complete blood count (CBC) parameters. CONCLUSIONS: Although the high level of plasma syndecan-1 was demonstrated in patients with AML compared to the control group, there was no significant difference with respect to age, FAB subtype, and type of response to treatment nor with the patient outcome, and also no significant association was established with any of the hematological parameters.