The prognostic value of soluble CD73 in patients with acute myeloid leukemia

Context
CD73, an ecto-5ʹ-nucleotidase, functions as an immune checkpoint by producing adenosine (ADO). This molecule suppresses immune activation through the adenosine A2A receptor, which is crucial for tumor growth and metastasis.


Aims
This study aimed to determine the plasma/serum level of soluble CD73 and its diagnostic and prognostic impact in acute myeloid leukemia (AML) patients. Additionally, the correlation between the soluble CD73 level and other prognostic markers, including cytogenetic abnormalities, response to treatment, and patient survival, was to be investigated.


Settings and design
The study was divided into two phases: the initial phase was a case–control study, while the subsequent phase was a prospective study that was conducted at the clinical hematology department of the internal medicine department at Ain Shams University Hospitals.


Patients and methods
The investigation was conducted between 2022 and 2023 on 38 patients diagnosed with AML.


Results
The initial level of soluble CD73 was significantly elevated in the patient group compared with the control group, demonstrating a high degree of statistical significance between the two groups. A highly significant inverse correlation was observed between overall survival (OS) and follow-up levels of soluble CD73; however, no significant correlation was found between the initial level of soluble CD73 and OS. There was a significant relation between soluble CD73 post-treatment level and the patient’s response, being higher in the resistant group and the lowest level in the group that was in remission.


Conclusion
Soluble CD73 initial level (before chemotherapy) in newly diagnosed AML patients was elevated in comparison to healthy individuals. OS was inversely correlated with the level of soluble CD73 after chemotherapy, which may help predict the prognosis after induction of chemotherapy. Resistant cases had significantly higher levels of soluble CD73 at follow-up (after chemotherapy) in comparison to patients in remission, and that may indicate its role in resistance to chemotherapy. Anti-CD73 could be a light path as a line of therapy in AML.