High expression of CD74 is associated with poor prognosis and tumor immune infiltration in Acute Myeloid Leukemia

To investigate the expression patterns of the CD74 gene in Acute Myeloid Leukemia (LAML), its clinical prognostic significance, and its association with the tumor microenvironment (TME). Data from public databases, including TCGA and GTEx, were integrated to analyze the differences in CD74 expression between LAML tissues and normal controls; perform subgroup analysis based on clinical and pathological characteristics; evaluate its prognostic value using survival analysis and ROC curves; elucidate its potential immune regulatory mechanisms through the CIBERSORT algorithm and functional enrichment analysis. CD74 was significantly overexpressed in LAML tissues, with higher expression observed in the monocyte-derived subtypes (M4–M7) and in patients with high white blood cell counts (P < 0.05). High CD74 expression is significantly associated with poor overall survival in patients with LAML(P < 0.01). Immunohistochemical analysis revealed that CD74 expression was positively correlated with the abundance of memory B cells, monocytes, and M2 macrophages, and was primarily enriched in antigen-presenting and immune response pathways. High CD74 expression is associated with poor prognosis in patients with LAML and may promote disease progression by reshaping the immune microenvironment; it holds promise as a new prognostic marker and immunotherapy target.