Expression and prognostic significance of cathepsin D in acute myeloid leukemia

This study investigates the expression level of cathepsin D (CTSD) in the serum of patients with acute myeloid leukemia (AML) and its clinical significance and evaluates its potential value as a prognostic biomarker for AML. Bioinformatics analysis was performed to examine the expression profile and prognostic correlation of CTSD in AML. A total of 63 newly diagnosed AML patients and 50 healthy controls were enrolled in validation. Serum CTSD levels were measured using enzyme-linked immunosorbent assay, and their associations with clinical characteristics, treatment response, and prognosis were analyzed. Bioinformatics analysis showed CTSD may be a potential factor for poor prognosis in AML patients. Validation through sample analysis confirmed that the serum CTSD level in AML patients (400.00 ± 240.00 pg/mL) was significantly higher than in healthy controls(P < .001). CTSD expression was positively correlated with peripheral white blood cell count and bone marrow blast percentage. Patients who achieved complete remission after chemotherapy had significantly lower CTSD levels than those in the non-remission and partial remission groups. Survival analysis revealed that patients with high CTSD expression had significantly shorter disease-free survival (P = .021) and overall survival (P = .026). Risk stratification showed the level of CTSD was lower in favorable group than that in intermediate and poor groups. Multivariate regression analysis showed that CTSD was a significant independent risk factor in both the overall survival and disease-free survival models, with a hazard ratio 1.002. The expression level of CTSD in peripheral serum is significantly elevated in AML patients and is closely associated with disease progression and poor prognosis. CTSD may serve as a potential biomarker for AML prognostic assessment.