Elevated CA15-3 Levels in Myeloid Disorders: Clinicopathological Correlation

Abstract

Background: Serum tumor markers are beneficial to patients with advanced cancer because they help in early diagnosis, determining prognosis, predicting response to certain medications, and monitoring therapy. The prognostic value of cancer antigen 15-3 (CA15-3) serum-level changes in breast cancer is very well established. The main cause behind the elevation of CA 15-3 is metastatic breast carcinoma. In this study, we will run a record review to study comprehensively the clinical association between chronic myeloid disorders and CA15-3 elevation.

Method: In this retrospective study, we run CA15-3 on 106 patients with different myeloid disorders diagnosed between 2008 and 2021 from several tertiary care centers in Saudi Arabia, Jeddah, majority of which (38 cases) were diagnosed with chronic myeloid leukemia (35.8%). Others had essential thrombocytosis (22.6%), chronic myeloproliferative neoplasm (20.8%), myelofibrosis (7.5%), acute myeloid leukemia (4.7%), myelodysplastic syndrome (4.7%), and polycythemia vera (3.8%).

Result: An increase in CA15-3 was seen in 50% of all cases. In particular, polycythemia vera showed an elevation in 100% of the cases (4 out of 4). Second in expressivity is myelodysplastic syndrome (80%, 4 out of 5 cases). Close in value is myelofibrosis (75%, 6 out of 8 cases). The least association is noted between CA15-3 and essential thrombocytosis (16.7%, 4 out of 24 cases).

Conclusion: When CA15-3 levels are considered during the time of myeloid disorder diagnosis, it shows an independent predictive value. More research is needed to determine the utility of these serum biomarkers in myeloid disorders decision-making. This is a thorough case series of chronic myeloid disorders inclusive of all myeloproliferative neoplasms besides myelodysplastic syndrome describing the association with CA15-3.