CD7-positive leukemic blasts with mutations predict poor prognosis in patients with acute myeloid leukemia.

Background: mutations can be detected in premalignant hematopoietic stem cells and are primarily associated with clonal hematopoiesis of indeterminate potential; however, current evidence does not support assigning them to a distinct European Leukemia Net (ELN) prognostic risk stratification. CD7 is a lymphoid antigen expressed on blasts in approximately 30% of acute myeloid leukemia (AML), and its role in AML remains unclear and depends on subgroup evaluation. This study investigated the prognostic value of mutation combined with CD7 expression in AML.

Methods: We retrospectively analyzed the clinical data of 297 newly diagnosed non-M3 AML patients. According to the mutation and CD7 expression in AML cells, patients were divided into the -mutated/CD7-positive (CD7+), -mutated/CD7-negative (CD7-), -wild-type/CD7+, and -wild-type/CD7- groups.

Results: The -mutated/CD7+ group had lower complete remission rates and higher relapse rates. Importantly, these patients had significantly shorter overall survival (OS) and relapse-free survival (RFS). Furthermore, multivariate analysis showed that CD7+ with mutation was an independent risk factor for OS and RFS.

Conclusion: CD7+ with mutation predicts a poor prognosis in AML patients, and the immunophenotype combined with molecular genetic markers can help to further refine the current risk stratification of AML.