Targeting CD33 for acute myeloid leukemia therapy

• Published in: BMC cancer Vol. 22; no. 1; p. 24
• Main Authors: Liu, Jingjing, Tong, Jiayin, Yang, Haiping
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 03.01.2022; BioMed Central; BMC
• Subjects: Acute myeloid leukemia; Adolescent; Adult; Aged; Aged, 80 and over; Antigens; Bone marrow; Bone Marrow - metabolism; Cancer; Care and treatment; CD33; Chemotherapy; Child; Female; Flow Cytometry; fms-Like Tyrosine Kinase 3 - genetics; Genes; Genetic aspects; Health aspects; Hematology; Humans; Immunotherapy; Kaplan-Meier Estimate; Karyotypes; Leukemia; Leukemia, Myeloid, Acute - metabolism; Leukemia, Myeloid, Acute - mortality; Male; Medical prognosis; Middle Aged; Mutation; Myelocytic leukemia; Nonlymphoid leukemia; Nucleophosmin - genetics; Patients; Point mutation; Prognosis; Proportional Hazards Models; Sialic Acid Binding Ig-like Lectin 3 - metabolism; Statistical analysis; Statistics; Stem cell transplantation; Survival analysis; Survival Rate; Testing; Young Adult; China; Acute myeloid leukemia; Immunotherapy; CD33
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-021-09116-5

The aim of this study was to analyze the level of CD33 expression in patients with newly diagnosed AML and determine its correlation with clinical characteristics. Samples were collected for analysis from AML patients at diagnosis. We evaluated the level of CD33 expression by flow cytometry analysis of bone marrow. Chi-square or t- tests were used to assess the association between the high and low CD33 expression groups. Survival curves were generated by the Kaplan-Meier and Cox regression model method. In this study we evaluated the level of CD33 expression in de novo patients diagnosed from November 2013 until January 2019. The mean value of 73.4% was used as the cutoff for the two groups. Statistical analysis revealed that 53 of the 86 (61.2%) AML patients were above the mean. Although there was no statistical significance between CD33 expression level and gene mutation, FLT3 mutation (P = 0.002) and NPM1 mutation (P = 0.001) were more likely to be seen in the high CD33 group. The overall survival (OS) was worse in the high CD33 group (39.0 m vs. 16.7 m, x  = 13.06, P < 0.001). The Cox survival regression display that the CD33 is independent prognostic marker (HR =0.233,p = 0.008). Univariate analysis showed that the high expression of CD33 was an unfavorable prognostic factor. Of the 86 patients, CD33-high was closely related to the patients with normal karyotype (x  = 4.891,P = 0.027), high white blood cell count (WBC, t = 2.804, P = 0.007), and a high ratio of primitive cells (t = 2.851, P = 0.005). These findings provide a strong rationale for targeting CD33 in combination with chemotherapy, which can be considered a promising therapeutic strategy for AML.