Prognostic effect of CTLA4/LAG3 Expression by T-Cells Subsets on Acute Myeloid Leukemia Patients

El Dosoky, Wesam; Aref, Salah; El Menshawy, Nadia; Ramez, Ahmed; Abou Zaid, Tarek; Aref, Mohamed; Atia, Doaa

doi:10.31557/APJCP.2024.25.5.1777

Prognostic effect of CTLA4/LAG3 Expression by T-Cells Subsets on Acute Myeloid Leukemia Patients

Document Type : Research Articles

Authors

¹ Hematology Unit, Mansoura University Oncology Center, Mansoura University, Egypt.

² Mansoura University Oncology Center, Mansoura University, Egypt.

³ Mansoura University Oncology Center, Mansoura Faculty of Medicine, Mansoura University, Egypt.

10.31557/APJCP.2024.25.5.1777

Abstract

Background: Deregulation of immune checkpoint is an important point in cancer evolution as well as patients outcome. T-cells is an important arm in immunity against cancer. This study aimed to assess CTLA4/LAG3 expression on different T-cell subsets and its effect on disease outcome. Methods: This study included 81 newly diagnosed Egyptian adult AML patients. For each one of the patients CTLA4/ LAG3 expression on T-cell subsets was identified by flowcytometry before start of induction chemotherapy. Results: Total CD3 count in AML patients was lower than control. LAG3 expression were significantly higher in total CD3, T-cell subsets (CD4, CD8) as compared to healthy control. Moreover, co-expression of LAG3/CTLA4 on T-cell subsets were significantly higher in AML as compared to healthy control . NPM-/ FLT3+ was significantly associated with high LAG3 expression in T-cells subsets as compared to other molecular subtypes. Shorter OS, DFS were significantly associated with higher expression of LAG3 on T-cells subsets as compared to patients harbor low expression. COX regression analysis revealed that high expression of CD3/LAG3, CD4/LAG3, CD8/LAG4, CD3/CTLA4/LAG3 were considered a poor prognostic risk factor. Conclusion: High LAG3/CTLA4 expression could predict AML Patients’ outcome Conclusion: Our findings indicated that high expression of LAG3/CTL4 on T cells subsets identify a subgroup of AML patients with poor prognosis.

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