Expression Difference And Prognostic Significance Of CD7 In AML Patients With Wild Type And Mutant Of CEBPA

Objective:Analysis of clinical and laboratory features in CD7+ acute myeloid leukemia(AML)patients.Exploring the value of CD7 expression in patients with AML.Evaluating the relation between CD7 expression and CEBPA mutation rate.Clarifying the prognostic value of CD7+ in AML patients with wild-type(WT)or mutant-type(MT)CEBPA.Method:298 newly diagnosed non-M3 AML patients were enrolled in this study.The cases were divided into 2 groups according to the CD7 expression,and the clinical and laboratory characteristics of the two groups were analyzed.Survival analysis was performed by Kaplan-Meier method for defining the role of CD7 in prognostic evaluation.According to the CEBPA mutation,patients were divided into CEBPA wild type group and CEBPA mutant group.We used chi-square test to determine the relationship between CD7 expression and CEBPA mutation,then used Kaplan-Meier method to evaluate the effects of CEBPA mutation on survival and prognosis in CD7+group.We aimed to establish a new risk stratification model based on CD7 expression and CEBPA mutation in AML patients.Results:Among the 298 AML patients,109 cases were CD7-positive(CD7+),representing 36.6%of the total.Comparing to the CD7-group,the CD7+ group had lower platelet counts(P=0.020),higher CEBPA mutation(single or double)rates(P=0.000)and younger ages(P=0.017).There were no statistical difference between CD7+ group and CD7-group in complete remission rate(CR),recurrence rate(RR)and overall survival(OS)(P>0.05),while the disease-free survival(DFS)of CD7+patients(42 months)was significantly longer than that in CD7-patients(13 months)(P=0.025).Subgroup prognostic analysis showed a lower CR rate(P=0.001)and a higher RR(P=0.023)in CD7+ group comparing to CD7" group in AML patients with wild type CEBPA.However,there were no statistical difference of OS and DFS in the two groups mentioned above(P>0.05).There were no statistically difference of CR and RR between CD7+ group and CD7-group in AML patients carrying mutant-type CEBPA(P>0.05),but the former had longer OS(P=0.019)and DFS(P=0.010)than the latter.Based on the CD7 expression and CEBPA mutation,we divided the 298 cases into 3 subgroups,named as CD7+-CEBPA WT group,CD7+-CEBPA MT group and CD7-group.The 3-year OS of the 3 groups were 80.2%,48.0%and 30.6%,respectively(P<0.001);And the 3-year DFS were 74.1%,37.4%and 22.2%,respectively(P<0.001).Conclusion:The CEBPA mutation rate was higher in CD7+ AML patients then CD7-patients.CD7 expression has different prognostic significance in AML patients carrying the wild-type or mutant-type CEBPA.Based on CD7 expression and CEBPA mutation,we can establish a new risk stratification model in AML patients for guiding clinical work better.