The impact of CD25/CD200 different expression patterns on acute myeloid leukemia patients

Immunophenotyping via flow cytometry (FC) is a rapid technique for predicting outcomes in acute myeloid leukemia (AML). Cluster of differentiation 25 (CD25) is highly expressed in leukemia stem cells (LSCs), and CD25-positive AML blasts that have an LSC-like gene expression profile. CD200 is consistently overexpressed in AML LSCs when compared with healthy hematopoietic stem cells and their corresponding blast cells. This study aimed to evaluate the impact of CD25/CD200 different expression patterns on newly diagnosed AML patients. For that, 40 AML adult patients were enrolled and assessed using FC to determine CD25 and CD200 surface expression on leukemic blasts. Patients were monitored for clinical features, laboratory findings, response to the induction therapy, overall, and disease-free survival. We reported that the CD25/CD200 double-positive group was significantly associated with unfavorable cytogenetic risk; they also had the poorest response to induction therapy compared to other expression pattern groups. Logistic regression analyses confirmed that CD25/CD200 co-expression is an independent predictor of poor response to induction therapy. Receiver operating characteristic (ROC) curve analysis showed that combining CD25 and CD200 expression provided a better predictive accuracy for treatment response compared to each marker alone. In conclusion, CD25 and CD200 immunophenotypic co-expression was associated with unfavorable cytogenetic risks, lower rates of complete remission following induction therapy, reduced overall survival, disease-free survival, and higher mortality rates. Given the limited sample size, subgroup imbalance, and wide confidence intervals, these findings should be interpreted cautiously as exploratory associations and hypothesis-generating and cannot confirm an independent prognostic role for CD25/CD200 co-expression.