Geduk Ayfer, Atesoglu Elif B, Mehtap Ozgur, Demirsoy Esra T, Menguc Meral U, Tarkun Pinar, Hacihanefioglu Abdullah, Balcı Sibel
Department of Hematology, Medical Faculty, Kocaeli University, İzmit, Kocaeli Turkey.
Bone Marrow Transplantation Center, Koç University Hospital, İstanbul, Turkey.
Indian J Hematol Blood Transfus. 2022 Jul;38(3):464-472. doi: 10.1007/s12288-021-01473-2. Epub 2021 Jul 27.
Purpose: We aimed to evaluate the expression level of programmed death ligand-1 (PD-L1) and its effects on prognosis in acute myeloid leukemia. Methods: The flow cytometry was used to detect PD-L1 expression on leukemic cells of 86 de novo acute myeloid leukemia patients with longitudinal follow-up. Results: Median follow-up was 13 (0-73) months. The mean of expression level was 3.22 ± 0.47 at diagnosis and ranged from 0 to 28%. PD-L1 expression tended to be lower in patients with acute promyelocytic leukemia (2.47 ± 1.08, = 0.09) but there was no significant difference between neither diagnostic nor cytogenetic subgroups. There was no difference in PD-L1 levels between the patients who achieved complete remission (3.4 ± 0.61) and those who did not (2.91 ± 0.72, = 0.94). The patients with low PD-L1 at diagnosis (median 25 mo [95% CI; 0-56.7]) had a longer overall survival compared with high PD-L1 (median 13 mo [95% CI; 5.52-25.17], = 0.079). PD-L1 expression was lower at relapse (2.04 ± 0.79) compared to initial diagnosis (4.52 ± 0.93, = 0.049). The patients who had overall survival longer than 1 year showed lower PD-L1 expression at relapse (0.66 ± 0.93) compared with who had not (5.06 ± 4.28, = ). A negative correlation between CD33 and PD-L1 (r = - 0.303, = 0.005) was detected. Conclusion: Despite its low expression levels, PD-L1 appears to be a clinically important prognostic factor. The negative correlation determined between PD-L1 and CD33 supports the combination approach of PD-L1 inhibitors and CD33 targeted immunotherapies.
The online version contains supplementary material available at 10.1007/s12288-021-01473-2.
目的：我们旨在评估程序性死亡配体-1（PD-L1）的表达水平及其对急性髓系白血病预后的影响。方法：采用流式细胞术检测86例初发急性髓系白血病患者白血病细胞上PD-L1的表达，并进行长期随访。结果：中位随访时间为13（0 - 73）个月。诊断时表达水平的平均值为3.22±0.47，范围为0%至28%。急性早幼粒细胞白血病患者的PD-L1表达倾向于较低（2.47±1.08，P = 0.09），但在诊断亚组和细胞遗传学亚组之间均无显著差异。达到完全缓解的患者（3.4±0.61）和未达到完全缓解的患者（2.91±0.72，P = 0.94）的PD-L1水平无差异。诊断时PD-L1水平低的患者（中位生存期25个月[95%CI；0 - 56.7]）与PD-L1水平高的患者相比总体生存期更长（中位生存期13个月[95%CI；5.52 - 25.17]，P = 0.079）。与初始诊断时（4.52±0.93）相比，复发时PD-L1表达较低（2.04±0.79，P = 0.049）。总体生存期超过1年的患者复发时的PD-L1表达（0.66±0.93）低于未超过1年的患者（5.06±4.28，P = ）。检测到CD33与PD-L1之间存在负相关（r = - 0.303，P = 0.005）。结论：尽管PD-L1表达水平较低，但它似乎是一个具有临床重要性的预后因素。PD-L1与CD33之间的负相关支持了PD-L1抑制剂与CD33靶向免疫疗法的联合应用方法。
在线版本包含可在10.1007/s12288-021-01473-2获取的补充材料。
