Evaluation of plasma progranulin level and the estimation of its prognostic role in adult patients with de novo acute myeloid leukemia

Abstract

BACKGROUND: Acute Myeloid leukemia (AML) is a clonal, malignant disease of hematopoietic tissues that is characterized by the accumulation of blast cells, principally in the marrow, and impaired production of normal blood cells. Progranulin (PGRN) is a multifunctional secreted glycoprotein implicated in tumorigenesis, development, inflammation, and repair. High PGRN expression was reported as a prognostic marker in many types of nonhematological and limited hematological malignancies. AIM OF STUDY: To evaluate the level and prognostic significance of PGRN in adult patients with de novo acute myeloid leukemia. PATIENTS, MATERIALS AND METHODS: This analytic cross-sectional study was conducted on 60 adult de novo AML patients who were newly diagnosed from December 2021 to October 2022 in the Haematology Department of Baghdad Teaching Hospital in Medical City. A total of 28 healthy individuals were included in this study as a control group. The diagnosis was based on morphology, immunophenotyping, and genetic studies of the peripheral blood and/or bone marrow aspirate samples in the National Center of Teaching Laboratories of the Medical City in Baghdad. Measurement of plasma PGRN level was done by double-sandwich enzyme-linked immunosorbent assay (ELISA) technique using PGRN ELISA kit. RESULTS: Plasma PGRN level was significantly higher in AML patients than in controls, and also was higher in patients who did not achieve remission. Plasma PGRN level shows a strong positive correlation with the peripheral and bone marrow blast percentages and insignificant correlation with age, gender, total leukocyte count, hemoglobin level, and platelets. There was a statistically significant difference in the median of plasma PGRN level between M3 and non-M3 groups. CONCLUSIONS: PGRN is higher in AML patients at diagnosis than in the control group, with plasma level more in those with poor response to treatment and may be used as an independent risk factor in those patients.