Clinical and prognostic significance of cytokine receptor expression in adult acute lymphoblastic leukemia: interleukin-2 receptor α-chain predicts a poor prognosis

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Abstract

We quantitatively assessed the expression of cytokine receptors (interleukin-2 receptor (IL-2R), IL-3R, IL-4R, IL-5R, IL-6R, IL-7R, granulocyte-macrophage colony-stimulating factor R (GM-CSFR), G-CSFR, c-fms, c-mpl, c-kit and FLT3) in cells from 211 adults with acute lymphoblastic leukemia (ALL) by flow cytometry and determined their prevalence and clinical significance. Although all cytokine receptors were expressed to various degrees, the levels of IL-3R α-chain (IL-3Rα), IL-2Rα, IL-2Rβ, IL-7Rα, common-Rγ(γc), c-mpl, c-kit and FLT3 exhibited a wide spectrum ≥2000 sites/cell. Among them, IL-3Rα, IL-2Rα and FLT3 were highly expressed in B-lineage ALL, whereas IL-7Rα, γc and c-kit predominated in T-lineage ALL. Higher levels of IL-3Rα, IL-2Rα, c-kit and FLT3 correlated with the expression of CD13/33. Increased IL-2Rα levels related to the presence of Philadelphia chromosome (Ph), leukocytosis and shorter event-free survival (EFS). C-kit preferred in male. Elevated FLT3 levels correlated with age ≥60 years. Multivariate analysis in B-lineage ALL revealed only IL-2Rα (P=0.028) and Ph (P=0.020) as independent factors for EFS. These findings suggest that several cytokine receptors associated with certain cellular and clinical features, but IL-2Rα solely had a prognostic value and should be considered as a major prognostic factor for adult ALL that is comparable with Ph.

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