Prognostic Value of Transferrin Receptor-1 (CD71) Expression in Acute Lymphoblastic Leukemia

摘要

Background: Acute lymphoblastic leukemia (ALL) is the commonest childhood cancer.Transferrin receptor 1 (CD71) is a trans-membrane glycoprotein which has important role in iron homeostasisby acting as a gatekeeper regulating iron uptake from transferrin and is an attractive targetfor anti-cancer agents, particularly those that aim to induce lethal iron deprivation in malignant hematopoieticcells.Aim of the Work: To assess the prognostic value of Transferrin receptor -1 (CD71) in children withnewly diagnosed ALL.Patients and Methods: This study was carried out on 75 patients with newly diagnosed ALL. Transferrinreceptor-1 expression was analyzed on the bone marrow blasts by flow cytometry at time of diagnosiswith positive CD71 expression is considered when ≥20% of malignant cells express this markerwhile negative expression is considered when <20% of malignant cells express this marker.Results: Transferrin receptor-1 positive expression was detected in 45 patients (60%) while negativeexpression was found in the remaining 30 patients (40%). CD71 expression was significantly higher onT- ALL patients compared with B-ALL patients. Positive CD71 expression at diagnosis was significantlyassociated with bad clinical and laboratory prognostic factors as lymphadenopathy, higher whiteblood cell count, higher hemoglobin level, lower platelets count, and higher blast cells in peripheralblood and bone marrow and higher lactate dehydrogenase levels’. There were significant differences indisease free survival (DFS) and overall survival (OS) between positive and negative CD71 expressiongroups with significantly shorter DFS and OS in positive CD71 expression group compared to negativegroup.Conclusion and Recommendations: ‘Positive Transferrin receptor -1 (CD71) expression in patientswith ALL is adverse prognostic factor and should be taken in consideration in designing future therapeuticstrategies based on patient- specific risk factors’.