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NRP-1/CD304 expression in acute leukemia: a potential marker for minimal residual disease detection in acute leukemia

Background Neuropilin-1 (NRP-1, BDCA-4, or CD304) is a nontyrosine kinase coreceptor for semaphorins and vascular endothelial growth factor, involved in neural development and tumor angiogenesis. Objective The aim of this study was to evaluate NRP-1/CD304 expression in acute leukemia to be used as a potential marker for minimal residual disease (MRD) detection using flow cytometry. Materials and methods This study was conducted on 30 adults with newly diagnosed acute leukemia admitted to the Hematology Unit, Internal Medicine Department, Main Alexandria University Hospitals and Alexandria Research Institute within the period from February 2014 to December 2014, and 10 patients diagnosed with hypersplenism were also included as a control group. The following investigations were carried out for all patients: complete blood picture, bone marrow examination, and immunophenotyping using flow cytometry. Results This study showed that NRP-1/CD304 expression was statistically higher in B-lineage acute lymphoblastic leukemia (ALL) than in the acute myeloid leukemia and the control group (P = 0.002). There was a positive correlation between NRP-1/CD304 percentage expression and blast cell percentage in the bone marrow (P = 0.039). Follow-up of the patients on day 28 of induction chemotherapy revealed that NRP-1/CD304 expression was statistically higher in those who did not achieve complete remission than those who did (P = 0.035). Moreover, we observed that leukemic patients with extramedullary infiltration had statistically higher NRP-1/CD304 expression than those who did not have extramedullary infiltration (P = 0.023). All patients who achieved complete remission on day 28 of induction chemotherapy had negative MRD (<0.001). Conclusion It was observed that NRP-1/CD304 was expressed in almost all B-lineage ALL patients in variable degrees. It might be a useful marker in MRD detection of B-lineage ALL patients.