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Assessing Neutrophil Cd64 Expression: A Key Biomarker for Diagnosing Infections and Evaluating Antibiotic Therapy in Acute Leukemia Patients



Mohebbi A1 ; Saki N2, 4 ; Karimpourian H2, 3 ; Alizadeh S1
Authors
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Authors Affiliations
  1. 1. Department of Hematology and Blood Transfusion, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  3. 3. Department of Medical Oncology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  4. 4. Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Source: Iranian Journal of Blood and Cancer Published:2024

Abstract

Introduction: Patients with acute leukemia (AL) are at an increased risk of infection, particularly in acute or critical situations, where timely identification of the cause of infection is crucial. While traditional methods such as microbial cultures remain the gold standard, they require 24–48 hours for results. In recent years, novel biomarkers like neutrophil CD64 expression have been widely investigated as indicators of infection. However, the diagnostic utility of CD64 within the clinical context of AL patients, especially those who are neutropenic and undergoing treatment, has not been extensively studied. Therefore, this study aimed to assess the diagnostic potential of neutrophil CD64 expression in monitoring the progression of infection and evaluating antibiotic therapy in AL patients complicated by infection. Methods: Forty AL patients (20 in the infection group and 20 in the non-infection group), along with 40 healthy controls, were recruited. Data on the percentage of neutrophil CD64+ (%CD64+), CD64 index, C-reactive protein (CRP), white blood cell (WBC) count, and absolute neutrophil count (ANC) were collected. Results: Patients with infection exhibited higher %CD64+, CD64 index, and CRP levels compared to those without infection (p<0.001). The sensitivity of both %CD64+ and the CD64 index in diagnosing infection was 90%, while their specificities were 83.3% and 86.7%, respectively. Furthermore, in the infection group, both %CD64+ and the CD64 index were significantly down-regulated after effective antibiotic therapy (p<0.001). Conclusion: CD64 shows significant promise in enhancing diagnostic precision and in assessing the effectiveness of antibiotic therapy in AL patients. © 2024, Iranian Pediatric Hematology and Oncology Society. All rights reserved.