Semaphorin 4D (CD100) expression as a predictor for the response to induction therapy in pediatric patients with B-acute lymphoblastic leukemia

Semaphorin 4D (Sema4D)/(CD100) expression is upregulated in different human cancers, and it is associated with poor prognosis; however, its prognostic value in B-acute lymphoblastic leukemia (B-ALL) remains unclear. We aimed to study the prognostic value of Sema4D expression to predict response to induction therapy in pediatric patients with B-ALL. Sixty newly diagnosed pediatric patients with B-ALL were enrolled, and their peripheral mononuclear cells (PBMCs) were isolated for assessment of Sema4D expression by multiparametric flow cytometry before initiating therapy. Then, we followed up with the patients for their response to induction therapy. Sema4D expression is significantly higher in non-responders to induction therapy than in responders. Using the receiver operating characteristic (ROC) curve, Sema4D expression > 18% significantly identifies patients at risk for induction failure. Logistic regression analyses confirmed that Sema4D expression is significantly associated with poor response to induction therapy. CONCLUSION: PBMCs' Sema4D expression can be considered a potential marker for predicting the response to induction therapy in pediatric patients with B-ALL. So, it may serve to optimize treatment decisions for those patients. WHAT IS KNOWN: • Semaphorin 4D (Sema4D)/(CD100) expression is upregulated in different human cancers, and it is associated with poor prognosis. • However, its prognostic value in B-acute lymphoblastic leukemia (B-ALL) in pediatrics remains unclear. WHAT IS NEW: • We aimed to study the prognostic value of Sema4D expression to predict response to induction therapy in pediatric patients with B-ALL. • Sema4D expression can be considered a potential marker for predicting the response to induction therapy in pediatric patients with B-ALL. So, it may serve to optimize treatment decisions for those patients.