Immunophenotypic evaluation of interleukin-7 receptor alpha (cluster of differentiation 127) in acute leukemia

Abstract

Background
Acute leukemia (AL) comprising acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL), remains a significant clinical challenge. Interleukin-7 receptor alpha [IL7Rα, Cluster of differentiation (CD127)] is critical for lymphoid development and is frequently expressed in ALL.


Aim and objectives
This study aimed to evaluate the immunophenotypic expression of IL7Rα in newly diagnosed AL to determine its diagnostic value and prognostic significance.


Patient and methods
This study was conducted on 83 newly diagnosed individuals with AL (AML and ALL). All patients were diagnosed with AL following peripheral blood and bone marrow aspirate smear examinations and were tested for surface expression of CD127 by flow cytometry technique.


Results

CD127 expression was significantly higher in ALL compared with AML (
P
=0.037), with T-ALL showing the highest median expression. A CD127 percentage cutoff of greater than 6.11% demonstrated moderate diagnostic value in distinguishing ALL from AML (area under the curve: 0.679). Prognostically, CD127 expression showed a significant negative correlation with relapse free survival in B-ALL (
r
=–0.328,
P
=0.026), a strong negative correlation with relapse free survival (
r
=–0.673,
P
=0.033), and a moderate negative correlation with overall survival (OS) in T-ALL (
r
=–0.648,
P
=0.043). In Cox regression analysis, CD127 expression showed a trend toward significance for OS in the univariate model (
P
=0.053), though this effect was not maintained in the multivariate model, where age and response to treatment were the dominant factors.



Conclusion
CD127 expression is a reliable immunophenotypic marker for distinguishing ALL from AML. More importantly, the significant negative correlation with survival outcomes suggests that higher CD127 expression is associated with a more aggressive disease phenotype, particularly in ALL. While its independent prognostic value was overshadowed by established clinical factors in multivariate analysis, CD127 remains a valuable diagnostic adjunct and a potential prognostic biomarker that warrants further investigation, especially in the context of targeted therapeutic strategies.