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Can Immunoglobulin Expression Predict Survival in Patients With AML?

By: Sarah Campen, PharmD
Posted: Friday, September 11, 2020

High levels of immunoglobulin expression seem to be associated with poor overall survival in patients with acute myeloid leukemia (AML). A study in the European Journal of Haematology identified two distinct groups of patients with AML based on the expression of immunoglobulin and found that several gene mutations—including TET2 and KRAS—were more commonly seen in patients with higher levels of immunoglobulin expression.

“Assessment of immunoglobulin expression may serve as a useful marker for prognostic stratification, disease monitoring, and development of target therapy in AML patients,” stated C. Cameron Yin, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues.

The study assessed the expression of different classes of immunoglobulin in peripheral blood and bone marrow samples from 132 patients with AML. in addition to IgG, the researchers discovered myeloblasts in patients with AML expressing all classes of immunoglobulin—including IgM, IgA, IgD, IgE, Igκ, and Igλ. Using receiver operating characteristic curve analysis, patients were divided into high- and low-expression groups based on the determined cutoff values of IgG, Igκ, and Igλ—the three immunoglobulins with the highest overall levels of expression.

Among 125 patients with expression data available, 37 (30%) were in the high-expression group and 88 (70%) were in the low-expression group. Overall survival was significantly shorter in patients with AML in the high-expression group compared with the low-expression group for each of the three immunoglobulins analyzed: IgG (14 vs. 20 months), Igκ (9 vs. 20 months), and Igλ (13 vs. 21 months). Additionally, patients with high IgG expression had a higher white blood cell count (P = .02), the blasts more often showed monocytic differentiation (P = .001), and dysplasia was more common (P < .001).

Disclosure: The study authors reported no conflicts of interest.

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