Soluble CD206 and CD163 as novel prognostic biomarkers in adult acute myeloid leukemia

Abstract

Background Despite advances in chemotherapy, the prognosis of adult acute myeloid leukemia (AML) patients remains poor, with a 5-year survival rate below 25%. In the tumor microenvironment of AML, tumor-associated macrophages (TAMs) are very important in the microenvironment of AML tumors because they help leukemic cells to survive, grow and migrate. They also play a key role in how the disease progresses. M2 macrophages highly express both CD206 (mannose receptor, C type I, and CD163 (hemoglobin scavenger receptor), a monocyte/macrophage receptor, as markers for M2 macrophages. Soluble CD206 (sCD206) and CD163 (sCD163) emerge as prognostic players for hematopoietic neoplasms. This study aimed to assess the prognostic potential of sCD206 and sCD163 as serological markers in AML. The study included 60 AML patients and 20 healthy volunteers as controls. The levels of serological markers sCD206 and sCD163 were measured by ELISA, and their prognostic values were evaluated. Results Serum levels of sCD206 and sCD163 were statistically significantly (P < 0.001) higher in AML cases than in controls. AML patients were categorized into two subgroups based on the response outcome to induction therapy: 36 patients (60%) had complete response (CR), and the other 24 patients (40%) had refractory disease. Interestingly, based on response outcome, serum levels of sCD206 and sCD163 as well as total leukocytic count (TLC), absolute neutrophils count (ANC) and absolute lymphocyte count (ALC) were significantly higher (all P < 0.001) in refractory group than in CR group. Further, a significant positive correlation of both sCD206 and sCD163 with TLC, ANC and ALC was observed (all P < 0.001). Conclusion Levels of sCD206 and sCD163 emerge as promising prognostic biomarkers for AML outcome and progression.