CD25 expression and outcomes in older patients with acute myelogenous leukemia treated with plerixafor and decitabine

We investigated CD25 expression in older (60 years) patients with new acute myelogenous leukemia treated with decitabine and plerixafor. Patients resistant to therapy or survival 1 year had significantly higher percentages of CD25(pos) myeloid blasts in baseline bone marrow. CD25(pos) patients had an increased odds of resistance compared to CD25(neg) patients (p=.015). In univariate analysis, we found CD25(pos) patients had inferior survival compared to CD25(neg) (p=.002). In patients with intermediate risk cytogenetics, CD25(pos) status stratified patients associating with inferior survival (p=.002). In multivariable analysis, CD25 and TP53 mutations trended towards predicting remission to therapy but were not predictive of survival. Only remission status, ASXL1 and TET2 mutations were found to independently predict overall survival (OS). We conclude CD25 expression identifies patients at risk for resistance to hypomethylating chemotherapy but does not independently predict OS in an older AML population treated with decitabine and plerixafor.