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Background One of the crucial functions of the immune system is to prevent tumorigenesis, yet cancer occurs when malignant cells manage to evade immune surveillance via multiple strategies. Accordingly, this study aimed at assessing the potential significance of the novel immune checkpoint B and T lymphocyte attenuator ( BTLA ) as a prognostic marker in acute myeloid leukemia (AML), in addition to how it relates to response to treatment and patients’ survival. Thus, mRNA expression of BTLA was investigated on peripheral blood in 60 AML patients and 15 healthy controls. Results BTLA  expression was found to be significantly elevated ( p  = 0.024) in the tested AML cases in comparison with healthy controls. Moreover,  BTLA  was over-expressed in the CD13, CD33, and HLA-DR positive cases as compared to their negative counterparts ( p  = 0.003;  p  &lt; 0.001, and  p  = 0.001, respectively), and cases showing  BTLA  over-expression had significantly poorer overall survival times ( p  = 0.001) as confirmed by Kaplan–Meier survival analysis. Conclusion These observations suggest that  BTLA  over-expression may be associated with reduced immunity against tumors and could be recommended as a promising biomarker for unfavorable prognosis in AML .

The prospective prognostic value of the immune checkpoint BTLA expression in adult acute myeloid leukemia patients