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

Asian Pac J Cancer Prev. 2024 May 1;25(5):1777-1785. doi: 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.

Keywords: AML; CTLA4; LAG3; T cell :.

MeSH terms

  • Adolescent
  • Adult
  • Antigens, CD* / metabolism
  • Biomarkers, Tumor* / metabolism
  • CTLA-4 Antigen* / metabolism
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Leukemia, Myeloid, Acute* / immunology
  • Leukemia, Myeloid, Acute* / metabolism
  • Leukemia, Myeloid, Acute* / pathology
  • Lymphocyte Activation Gene 3 Protein*
  • Male
  • Middle Aged
  • Prognosis
  • Survival Rate
  • T-Lymphocyte Subsets* / immunology
  • T-Lymphocyte Subsets* / metabolism
  • Young Adult

Substances

  • Lymphocyte Activation Gene 3 Protein
  • CTLA-4 Antigen
  • Lag3 protein, human
  • CTLA4 protein, human
  • Antigens, CD
  • Biomarkers, Tumor