The surprising relationship between CD38 and lipid metabolic in acute myeloid leukemia

Background: CD38 is a surface protein playing a pivotal role in the initiation, relapse, and progression of acute myeloid leukemia (AML). In the meanwhile, CD38 catalyzes the conversion of NAD, which is required for mitochondrial fatty acid and amino acid oxidation. This study aimed to explore the relationship between CD38 and lipid metabolism in AML. Methods A total of 268 samples from newly diagnosed AML patients excluding acute promyelocytic leukemia (APL) were collected and analyzed retrospectively to investigate the expression profile and predict the effectiveness of CD38 in AML. Then, qRT-PCR was applied to analyze the expression of enoyl-CoA hydratase short chain 1 (ECHS1) in AML bone marrow. Results The result demonstrated that high CD38 level was an independent beneficial prognostic factor for AML patients ( p =  0.017). Moreover, CD38 showed significant negative correlation with ECHS1 in AML (r = -0.498, p  = 0.0002). ECHS1 overexpression was associated with decreased OS ( p =  0.007), and in the multivariable analysis, elevated ECHS1 level was also an independent poor prognostic factor ( p =  0.023). Conclusions Our study indicates that CD38 overexpression could be a favorable prognostic factor for newly diagnosed AML patients. CD38 is negative associated with lipid metabolic gene ECHS1 expression. This study provides new basis for anti-metabolite treatment and prognosis judgment of AML.