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Serum Proteomics Screening Intercellular Adhesion Molecule-2 Improves Intermediate-Risk Stratification in Acute Myeloid Leukemia
27 Pages Posted: 11 Apr 2022
More...Abstract
Background: The clinical risk classification of acute myelocytic leukemia (AML) is largely based on cytogenetic and molecular genetic detection. However, the optimal treatment for intermediate-risk AML patients remains uncertain. Further refinement and improvement of prognostic stratification are therefore necessary.
Methods Lable-free proteomics was used to identify the differential abundance of serum proteins in AML patients. Transcriptomic data were combined to identify key altered markers that could indicate the risk rank of AML patients. The survival status was assessed by Kaplan-Meier and multivariate Cox regression analyses.
Findings: We delineated serum protein expression in a population of AML patients. Many biological processes were influenced by the identified differentially expressed proteins. Association analysis of transcriptome data showed that ICAM2 had a higher survival prediction value in the intermediate-risk AML group. ICAM2 was detrimental for intermediate-risk AML, regardless of whether patients received bone marrow transplantation. ICAM2 well distinguishes the intermediate group of patients, whose probability of survival is comparable to that of patients with the ELN-2017 according to the reference classification. In addition, newly established stratified clinical features were associated with leukemia stem cell scores.
Interpretation: Inclusion of ICAM2 expression into the AML risk classification according to ELN-2017 was a good way to transfer patients from three to two groups. Thus providing more information for clinical decision-making to improve intermediate-risk stratification in AML patients.
Funding Information: This work was supported by the Zhongnan Hospital of Wuhan University Science, Technology and Innovation Cultivation Fund [grant number ZNLH201902], and the Natural Science Foundation of China (NSFC) programme [grant number 81900116].
Declaration of Interests: The author reports no conflicts of interest in this work.
Ethics Approval Statement: This study was approved by the Ethics in Research Committee of the Zhongnan Hospital of Wuhan University in Wuhan, China.
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