The Role of CD36 Expression on Survival and Febrile Neutropenia in Patients with Acute Myeloid Leukemia

BACKGROUND: Acute myeloid leukemia (AML) is a clonal malignancy characterized by impaired hematopoietic differentiation. CD36, a transmembrane glycoprotein receptor for phospholipids, lipoproteins, and long-chain fatty acids implicated in chemoresistance was evaluated in our AML cohort for its association with febrile neutropenia (FEN) and overall survival (OS) as a potential biomarker of infectious risk. PURPOSE: To assess whether CD36 expression may be associated with FEN and OS in AML. METHODS: We conducted a retrospective single-center cohort study of patients with AML, evaluating flow cytometric CD36 expression and its associations with clinical variables, FEN, and OS during follow-up. RESULTS: Among 41 AML patients (median age, 61 years; 46.3% male), CD36 expression was <20% in 20 (48.8%) and ≥20% in 21 (51.2%). FEN occurred in 34 patients (82.9%), including 20/21 (95.2%) in the CD36 ≥ 20% group (p = 0.032). Patients with CD36 expression ≥20% also exhibited shorter OS and a significantly higher hazard of death on univariable Cox regression (HR 3.161, 95% CI 1.276-7.827; p = 0.013). CONCLUSION: Higher CD36 expression in AML may be associated with more frequent FEN and reduced OS, suggesting that CD36 may have potential clinical relevance as a biomarker of infection-related vulnerability and adverse prognosis.