CD45 correlates with adverse risk stratification, decreased treatment response and unfavorable survival profiles in elderly acute myeloid leukemia patients.

OBJECTIVE: This study aimed to explore the correlation of CD45 expression with clinicopathological features and treatment outcomes in elderly acute myeloid leukemia (AML) patients.

METHODS: One hundred and twenty one elderly patients with de novo AML were consecutively recruited in this prospective cohort study, bone marrow samples from all patients were collected and CD45 expression were measured with flow cytometry. Complete remission (CR), event-free survival (EFS) and overall survival (OS) were evaluated. The median follow-up duration was 15.0 (range 2.0-36.0) months.

RESULTS: CD45 high expression (CD45high) was associated with higher risk stratification in elderly AML patients (P= 0.021). The percentage of CD45high cases in CR patients was 16.4%, which was lower compared to non-CR patients (35.2%, P= 0.017), while no difference in percentage of CD45high cases was found between allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients and non-allo-HSCT patients (16.7% vs. 25.7%, P= 0.492). As to survival profiles, median EFS in CD45high patients was 6.0 (95% CI: 2.9-9.1) months, which was shorter than that in CD45 low expression (CD45low) patients (10.0 (95% CI: 7.2-12.8) months) (P= 0.002), and OS in CD45high patients was 16.0 (95% CI: 13.4-18.6) months, which was worse compared to CD45low patients (22.0 (95% CI: 17.0-27.0) months) (P= 0.010). In subgroup analysis, no difference of EFS and OS was found between CD45high patients and CD45low patients in favorable, intermediate or adverse risk subgroups.

CONCLUSIONS: CD45 correlates with adverse risk stratification, decreased treatment response and unfavorable survival profiles in elderly AML patients.