Abstract
Objective:This study was designed in order to identify the prognostic relevance of CD200 expression and soluble Cytotoxic T-lymphocyte antigen-4 (CTLA-4) levels in myelodysplastic syndrome (MDS) patients. Methods:The study included 57 MDS (37 intermediate and 20 high risk) patients and 10 controls. For all of included patients; CD200 expression was identified by flowcytometry on CD33 positive cells and soluble CTLA-4 (CD152) concentration was determined by ELISA. Results: CD200 positive expression was detected in 32/57 (56.1%) of MDS cases, the mean serum CTLA-4 concentrations were significantly higher in MDS patients as compared to controls (P<0.01). Significant association between high CD200 positive expression; high CTLA-4 concentration levels and MDS risk stages being higher in high risk MDS group as compared to intermediate risk one (P < 0.01). After 36-month follow-up; the subgroup of MDS patients with high expression of CD200; and high serum CTLA-4 concentrations showed high death rate and high frequency of acute myeloid leukemia transformation. Conclusions: CD200 positive expression could be considered as a new prognostic marker for risk stratification of MDS patients. CD200 expression may exert its effect through upregulation of CTLA-4.
Highlights
Myelodysplastic syndrome (MDS) is a complex clonal hemopoietic progenitor cell disorders that result from the evolution of aberrant clones and is characterized by an ineffective hematopoiesis and frequent cell apoptosis in the bone marrow (BM) and manifested by blood cytopenia’s (Montalban-Bravo and Garcia-Manero., 2018)
The CD200 expression was identified on bone marrow cells expressing CD33 and compared to that in MDS Cases Control Significance (n=57)
Despite that the over-expression of CD200 has been implicated in the pathogenesis of solid tumors, hematological malignancies and its expression is indicative of poor prognosis; very few studies have investigated its accuracy in MDS patients; which substantially differ from them
Summary
Myelodysplastic syndrome (MDS) is a complex clonal hemopoietic progenitor cell disorders that result from the evolution of aberrant clones and is characterized by an ineffective hematopoiesis and frequent cell apoptosis in the bone marrow (BM) and manifested by blood cytopenia’s (Montalban-Bravo and Garcia-Manero., 2018). Pathophysiological causes of this disease are diverse including genetic abnormalities within myeloid progenitors, altered epigenetics, changes in the bone marrow microenvironment and the immune disorder. CD200 receptor expression is restricted to myeloid cells. This study aimed to determine the prognostic relevance of CD200 expression and soluble CTLA-4 in MDS patients
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