Dynamics of Soluble HLA-G and the 14-bp Insertion/Deletion Polymorphism as Predictors of Therapeutic Response in Acute Myeloid Leukemia
DOI:
https://doi.org/10.54133/ajms.v10i2.2861Keywords:
Acute myeloid leukemia, Chemotherapy response, Leukemic burden , Soluble HLA-GAbstract
Background: Acute myeloid leukemia (AML) exploits immune escape mechanisms such as human leukocyte antigen-G (HLA-G), a non-classical HLA-I molecule involved in immune checkpoints and associated with the 14-bp insertion/deletion (Ins/Del) polymorphism for cancer prognosis. Prospective data regarding the dynamics of these parameters and their relation to therapy outcomes in AML patients remains limited. Objectives: Determine the relationship between the serum level of soluble human leukocyte antigen-G (sHLA-G) and the 14-bp deletion/insertion (Ins/Del) polymorphism of the sHLA-G gene in AML patients before and after chemotherapy. Methods: A longitudinal study with a prospective follow-up was executed. Forty-six adult patients diagnosed with AML were recruited. ELISA was used to measure serum levels of sHLA-G at diagnosis (T0) and six months after induction chemotherapy (T1). PCR genotyping was done on the HLA-G 14-bp polymorphism. This study focuses on the interaction of sHLA-G dynamics and genotype with the outcomes of clinical response, which could be Complete Remission (CR) or Non-Remission (NR). Results: sHLA-G levels reduced markedly after induction chemotherapy (28.5±15.3ng/mL at T0 vs. 7.6±6.1ng/mL at T1, p<0.001). Baseline sHLA-G values greater than 30ng/mL were significant predictors of non-response to treatment, demonstrating 82% sensitivity and 70% specificity. However, there were no significant variations in the distribution of HLA-G 14-bp genotypes between responders and non-responders (p=0.45). Conclusions: sHLA-G is a sensitive and dynamic biomarker of leukemic load; high baseline levels are significantly associated with non-response to induction therapy. In contrast, the HLA-G 14-bp polymorphism was not identified as an independent predictor of therapeutic response in this cohort.
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