Interleukin-27 and interleukin-35 in de novo acute myeloid leukemia: expression and significance as biological markers

Abstract

Heba A Ahmed,1 Ahmed M Maklad,2,3 Safaa AA Khaled,4 Ashraf Elyamany5,6 1Department of Clinical Pathology, Faculty of Medicine, Sohag University, Sohag, Egypt; 2Department of Clinical Oncology and Nuclear Medicine, Sohag University Hospitals, Sohag, Egypt; 3Department of Radiation Oncology, King Fahad Medical City, Riyadh, KSA; 4Department of Internal Medicine, Clinical Hematology Unit, Faculty of Medicine/Unit of Bone Marrow Transplantation, South Egypt Cancer Institute, Assiut University, Assiut, Egypt; 5Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt; 6Department of Medical Oncology, King Saud Medical City, Riyadh, KSACorrespondence: Safaa AA KhaledDepartment of Internal Medicine, Clinical Hematology Unit, Faculty of Medicine/Unit of Bone Marrow Transplantation, South Egypt Cancer Institute, Assiut University Hospital, 8 th  floor, PO Box 71111, Assiut, EgyptTel [phone]Email [email protected] and objectives: IL27 and IL35 are regulatory T cells (T-regs) related cytokines; they were accused in eukemogenesis of acute myeloid leukemia (AML). This study aimed to assess the expression of these cytokines in de novo AML and investigate their role as biomarkers.Subjects and methods: Seventy newly diagnosed patients with primary AML and 30 matched healthy volunteers were recruited. AML diagnosis was confirmed with flowcytometric and immunophenotypic analyses, while ELISA was used to assess serum levels of IL27 and IL35 in patients and controls. Receiver operating characteristic curve analysis was used to estimate IL27 and IL35 optimum cutoff values for predicting AML.Results: Serum levels of both cytokines were significantly higher in AML patients than controls (P<0.001), with no effect of gender or French-American-British subtypes. Significant correlations of IL27 and IL35 with poor prognostic factors and with each other were detected in patients only. IL27 optimum cutoff for predicting AML was >43, AUC (0.926) with a sensitivity 74% and specificity 96.6% (P<0.001), while for IL35>27.8, AUC (0.972) with 88% and 98% sensitivity and specificity, respectively (P<0.001).Conclusion: Conclusively, this study proved that IL27and IL35 could identify AML patients from healthy subjects, and their overexpression denotes poor prognosis. Based on the simplicity and wide availability of their detection technique we recommend the inclusion of IL27 and IL35 in the diagnostic/prognostic workup of AML; however, further longitudinal research is needed to prove their exact prognostic value.Keywords: acute myeloid leukemia (AML), regulatory T cells, flowcytometry, IL27, IL35

Keywords

• Acute myeloid leukemia (AML)
• regulatory T cells
• flowcytometry
• IL 27
• IL 35