OBJECTIVETo explore the expression and clinical significance of PD-L1, heat shock protein 90 (HSP90) and HSP90α in the serum of patients with acute leukemia (AL) of different types and disease stages.

METHODSA total of 84 AL patients from January 2013 to October 2016 in our hospital and 20 healthy persons as controls were selected. All the samples of serum or bone marrow were separated. The protein expression levels of serum HSP90, HSP90α were detected by ELISA. The flow cytometry was used to detect PD-L1 expression. The relationship of the expression level of PD-L1, HSP 90, and HSP90α with clinical outcome was analyzed.

RESULTSThe expression levels of serum HSP90, HSP90α and PD-L1 positive rate in AL patients were significantly higher those that in control group (P<0.05), the expression levels of serum HSP90, HSP90α and PD-L1 positive rate of Al patients in remission were lower than those in newly diagnosed patients (P<0.05). The expression level of HSP90, HSP90α and PD-L1 positive rate in the relapsed AL patients were higher than those in newly diagnosed AL patients and patients in remission (P<0.05). There was no significant difference of HSP90 protein level and PD-L1 positive rate between newly diagnosed AML patients and ALL patients(P>0.05). HSP90α level of newly diagnosed AML patients was lower than that in newly diagnosed ALL (P<0.05). HSP90α and HSP90 levels and PD-L1 positive rate in no remission patients were significantly higher than those in complete remission patients (P<0.05). The HSP90α level in patients without recurrence decreased during chemotherapy. The HSP90α protein level was the lowest after the hematopoietic stem cell transplantation, but increased after relapse.

CONCLUSIONThe PD-L1,HSP90 and HSP90α play an important role in the developmental process of acute leukemia, which can be used as reference indications to assess clinical efficacy and prognosis.