Immunophenotypic Markers and Prognostic Outcomes in Acute Leukemia: A Systematic Review and Meta-analysis.

Acute leukemia is a heterogeneous group of hematological malignancies characterized by the uncontrolled proliferation of immature hematopoietic precursor cells in the bone marrow and peripheral blood. Advances in diagnostic technologies, particularly flow cytometric immunophenotyping, have significantly improved the ability to classify leukemia subtypes and assess disease prognosis. Immunophenotypic markers expressed on leukemic blasts provide important information regarding lineage differentiation, disease biology, and therapeutic response. Several studies have suggested that the expression of specific cluster of differentiation (CD) markers may influence clinical outcomes, including remission rates, relapse risk, and overall survival in patients with acute leukemia. The present study aimed to systematically review and analyze the prognostic significance of immunophenotypic markers in acute leukemia.

A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for studies published between 2000 and 2025. Eligible studies included those evaluating the association between immunophenotypic markers identified through flow cytometry and clinical outcomes in patients with acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL). Data regarding study characteristics, patient populations, immunophenotypic markers, and prognostic outcomes were extracted and analyzed. Hazard ratios and survival outcomes reported in the included studies were synthesized using a meta-analytic approach.

A total of 32 studies involving more than 6,000 patients were included in the final analysis. The findings demonstrated that several immunophenotypic markers have significant prognostic implications. Expression of CD34, CD7, and CD56 was consistently associated with adverse clinical outcomes, including lower overall survival and higher relapse rates. In contrast, markers such as CD10 and CD19, particularly in B-cell acute lymphoblastic leukemia, were associated with improved treatment response and favorable prognosis. Additionally, leukemia-associated immunophenotypes were found to be valuable in the detection of minimal residual disease and in predicting disease recurrence following therapy.

Overall, the results of this systematic review and meta-analysis highlight the important role of immunophenotypic markers in the diagnosis, risk stratification, and prognostic evaluation of acute leukemia. Integrating immunophenotypic data with cytogenetic and molecular findings may enhance individualized treatment approaches and improve clinical outcomes. Further large-scale prospective studies are required to validate the prognostic utility of emerging immunophenotypic markers and to establish standardized immunophenotyping panels for routine clinical practice