Evaluation of the plasma level of programmed death-ligand 1 and its relation with clinical and hematological parameters in pediatric patients with acute lymphoblastic leukemia

BACKGROUND: Acute lymphoblastic leukemia is a diverse illness characterized by the development of immature lymphoid cells. Programmed death-ligand 1 (PDL-1) is a protein 33-kDa glycoprotein encoded by the CD274 gene on chromosome 9p24. It plays a crucial role in immune modulation and serves as a checkpoint regulator. OBJECTIVE: To evaluate the plasma level of PDL-1 in pediatric patients with ALL and to correlate the plasma level PDL-1 with some hematological and clinical parameters. MATERIALS AND METHODS: This study was conducted on 63 pediatric patients, <14 years old (newly diagnosed) at the central teaching hospital of pediatrics, and 27 healthy children were included in this study as a control group. Plasma PDL-1 level measuring by enzyme-linked immunosorbent assay. RESULTS: PDL-1 was significantly higher in newly diagnosed patients with ALL 33.8 ng/ml for B-ALL and 43.5 ng/ml for T-ALL than controls (31.6 ng/ml), with P = 0.024. A substantial positive association was seen at the 0.05 level between PDL-1 and total white blood cell (WBC) count, pallor, and lymphadenopathy, whereas no significant correlation was found with other hematological and clinical parameters. CONCLUSIONS: Plasma level of PDL-1 was significantly higher in newly diagnosed patients with ALL than controls. Furthermore, there was significant positive correlation between PDL-1 with total WBC count, pallor, and lymphadenopathy, while there was no significant correlation with other hematological and clinical parameters.