The value of studying Programmed Death-1 +T cell immunoglobulin mucin 3 + exhausted T cells in patients of Acute Myeloid Leukemia

Background One extremely aggressive kind of clonal hematopoietic illness is acute myeloid leukemia (AML). T cell immunoglobulin mucin 3 (Tim-3) and programmed death-1 (PD-1) may alter the bone marrow environment, making patients more susceptible to infection and tumor progression due to T cell exhaustion. So, it may be used in the prediction of prognosis in AML in both newly diagnosed and relapsed cases. Therefore, this study aimed to investigate the importance of PD-1+ Tim-3+ fatigued T cells in AML patients, with the primary goal of determining their impact on clinical outcomes. Patients and methods This prospective study involved 40 participants, aged from 40 to 77 years, both sexes, with a recent diagnosis of AML. Patients were categorized into two groups: good prognosis group ( n =10), which showed complete remission, and poor prognosis group ( n =30), which showed noncomplete remission or death. Results The results indicate that patients with negative PD-1 expression had significantly better overall survival compared with those with positive expression. PD-1 served as a strong predictor of poor prognosis, showing a significant association ( P =0.004) and a high diagnostic performance [area under the curve (AUC)=0.808], with good sensitivity, specificity, and positive predictive value. Likewise, Tim-3 was also found to be a significant marker of poor prognosis ( P =0.009, AUC=0.772), demonstrating similarly strong diagnostic indicators. Conclusion The findings suggest that the expression of PD-1 and Tim-3 on exhausted T cells can predict a poor prognosis in newly diagnosed AML patients.