Pilot study on RECAF (Receptor for Alpha-Fetoprotein) expression in pediatric acute leukemia: insights from flow cytometry analysis

Abstract

Abstract Background Acute leukemia is the most common cancer in children, highlighting the importance of early diagnosis. RECAF is an AFP receptor that is abnormally re-expressed in various malignant tumors, serving as a promising biomarker for tumors. Aim This study aimed to assess the clinical utility of RECAF expression by flow cytometry immunophenotyping in pediatric de novo acute leukemia patients. Methods Our study was conducted in 80 pediatric patients with acute leukemia, comprising 40 newly diagnosed ALL patients, 40 newly diagnosed AML patients, and 40 age- and sex-matched non-malignant control subjects. Flow cytometric analysis for the Acute Leukemia panel and RECAF expression was performed on all subjects, along with other laboratory and clinical parameters. Results Our study revealed that RECAF expression was significantly higher in patients with acute leukemia than in controls. We also established a cutoff of ≥ 13.31% for positive RECAF expression by flow cytometry to distinguish RECAF-positive acute leukemia patients from FECAF-negative patients and normal controls. Conclusion Our findings suggest that RECAF could be an important biomarker for differentiating leukemic blasts and may become a useful tool for monitoring measurable residual disease in the future. Such advancements have the potential to improve clinical outcomes and enhance patient monitoring and management for this high-risk group.