Prognostic utility of CD184 in acute myeloid leukemia

Abstract

Background Chemokine induce directional migration of cells toward a gradient of chemotactic cytokines (chemotaxsis). CD184 is a chemokine receptor which regulates the localization of leukemic cells, and most leukemic cells respond to it, with increased adhesion, survival and proliferation. Aim The work was conducted to evaluate the role of CD184 in newly diagnosed patients with acute myeloid leukemia. Subject and method Eighty patients presented with de novo AML. Based upon the distribution of CD184 expression in our patients' population, we defined groups with low CD184 expression as group I (MFIR 4 to 8), intermediate CD184 expression as group II (MFIR 9 to 20), and high CD184 expression as group III (MFIR more than 21). Patients with acute myeloid leukemia were studied at first diagnosis and were previously untreated. After diagnosis, patients received chemotherapy and they were followed up for periods ranged of 24 months with special attention to clinical and laboratory markers of remission and relapse, taking care to estimate the date of first complete remission, date of relapse, death or last seen alive. Results patients were divided according to CD184 expression (MFIR) into 3 groups; group (I) with low expression (MFIRs ≤9) had a mean of 5.04 ± 1.48, group (II) with intermediate expression (MFIRs between 9 to 20) had a mean of 10.03 ± 0.45, and group (III) with high expression (MFIRs ≥20) had a mean of 30.25 ± 6.17. In the present study, we found no relation between CD184 expression levels in AML patients and the age of patients. Also, no significant relation was found between CD184 expression levels and the presence or absence of hepatosplenomegally and lymphadenopathy (P > 0.05 ). As regards to haematological data and MFIR of CD184 expression in AML patients, the mean leukocytic count was significantly lower in group (I) than in group (II) and group (III), and leucocytic count was significantly related to CD184 expression in the three groups. Also, the percentage of blasts in peripheral blood and bone marrow was significantly related to CD184 expression with P value < 0.05 while no significant relation was found with haemoglobin or platelets (P > 0.05). As regards to prognosis and MFIR of CD184 expression, group (I) showed 70% remission, 20% relapse and 10% death, while group (II) showed 33.33% remission and 66.67% relapse and group (III) showed 100% deaths meaning that high and intermediate CD184 expression were associated with low rates of remission and high frequency of relapse and death. We can conclude that CD184 expression can represent a useful prognostic tool for AML patients.