The Role of immunoregulator CD200 and CD47 in childhood acute lymphoblastic leukemia

Ayad, Esraa A.; Mahmoud, Reham H.; Alrayes, Mona H.; Osman, Randa A.

doi:10.21608/jram.2025.364954.1280

The Role of immunoregulator CD200 and CD47 in childhood acute lymphoblastic leukemia

Document Type : Original Article

Authors

¹ Clinical Pathology Department, Faculty of Medicine for Girl, Cairo, Al Azhar University, Egypt.

² Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt.

10.21608/jram.2025.364954.1280

Abstract

ABSTRACT
Background: About 30% of all pediatric cancers are acute lymphoblastic leukemia (ALL). Leukemia cells capacity to avoid immune system destruction contributes to the disease's onset and spread. One of the adaptive immune response's regulators is CD47. The immunoglobulin superfamily inhibitory receptor CD200R, which is mostly expressed on myeloid/monocyte lineage cells, and a subset of T cells, interacts with CD200. CD200R inhibits immunological responses mediated by T cells and monocytes. The existence of post-therapeutic leukemia cells in the bone marrow is known as minimal residual disease (MRD).
Aim of the study: To identify the role of CD200 and CD47 in pediatric ALL and highlight their possible role in MRD.
Methods: A hospital based cross sectional comparative study was carried out on 52 childhoods ALL cases from both B cell and T cell types. The expression pattern of CD200 and CD47 on blasts was assessed by flow cytometry. The MRD was detected on day 42. The cut of value of MRD is 0.01%.
Results: CD200 blast expression was significantly upregulated in B-ALL group compared to T-ALL group (P =0.017). There was no significant difference in CD47 blast expression between B-ALL and T-ALL (P=0.225). There was a statistically significant increase in hepatomegaly, splenomegaly, para-aortic lymphadenopathy and interior mediastinal mass in T-ALL group compared to B-ALL group (P=0.026, P=0.011, P=0.042 and P > 0.001) respectively.
Conclusion: T-All cases were presented with more metastatic course. B-ALL patients presented initially with significant increase in CD200 expression on blasts. There was no significant difference in CD47 blast expression between B-ALL and T-ALL. No significant difference was shown in MRD levels on day 42 between B-ALL and T-ALL patients

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