Clinical Impact of CD200 on Outcome of Acute Myeloid Leukemia: A Cohort Study from a Single Center

Abstract Purpose CD200, a trans-membrane protein belonging to the immunoglobulin superfamily, has been associated with a poor prognosis in acute myeloid leukemia(AML). We aimed to analyze the correlations between CD200 expression and prognostic significance in AML patients.Methods We retrospectively reviewed 160 AML patients evaluating the impact of CD200 expression on complete remission (CR), disease free survival(DFS), and overall survival (OS) in our institution between 2018 and 2021. Results CD200 were expressed in 100/160 (62.5%) cases, which were defined as the CD200 positive (CD200+) group and the rest of 60 cases were identified as CD200 negative(CD200-) group. A higher incidence of CD34 expression (P < 0.0001), NPM1 mutated(P=0.001) and unfavorable cytogenetic/molecular (P <0.0001) cases in CD200+ group. More intermediate cytogenetic/molecular status(P<0.0001) in CD200-group. Complete remission (CR) was evaluable achieved in70 patients (43.75%):34/100 (34%) in CD200+ and 36/60 (60%) in CD200- group (P = 0.001). CD200+ patients had significant lower probability to attain complete remission after first induction chemotherapy, both in univariate (P = 0.002) and multivariate (P = 0.023) analysis. In the whole population, CD200 expression had no significant effect on DFS (P = 0.837) and OS (P =0.155). In subgroup analysis we demonstrated that CD200 has obvious negative impact on OS in less-intensive approaches (P = 0.006) and in chemotherapy-only treatment (p=0.032) patients.Conclusion Expression of CD200 in AML contributes to low-remission rate and with a further worsening in long-term survival in patients receiving less-intensive approaches and chemotherapy-only treatment. CD200 positive is an indicator for low remission and poor prognosis in subgroups.