# Plasma levels of soluble podoplanin are higher in acute promyelocytic leukemia compared to other forms of acute myeloid leukemia

## TL;DR

Plasma levels of soluble podoplanin are higher in patients with acute promyelocytic leukemia compared to other types of acute myeloid leukemia, suggesting a potential diagnostic and pathogenic role.

## Contribution

The study demonstrates that soluble podoplanin levels can serve as a potential biomarker for diagnosing acute promyelocytic leukemia and understanding its coagulopathy.

## Key findings

- APL patients had significantly higher plasma soluble podoplanin concentrations than non-APL AML patients.
- Soluble podoplanin levels correlated with CD40L in APL cases, indicating a possible link to thrombo-inflammatory pathways.
- Elevated soluble podoplanin levels were observed in a higher proportion of APL patients compared to non-APL AML.

## Abstract

Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML) marked by a high incidence of coagulopathy. Podoplanin, a glycoprotein involved in platelet activation through interaction with CLEC-2, has recently been identified on leukemic promyelocytes and suggested as a potential contributor to APL coagulopathy. Identification of novel biomarkers and therapeutic targets for APL coagulopathy can potentially improve the outcomes of this condition

To explore whether levels of soluble podoplanin in plasma are different in APL, and to evaluate its association with laboratory and clinical outcomes in these patients

Samples were obtained from consecutive patients with APL at the time of diagnosis in an academic hospital. Biobank samples from 35 patients with non-APL AML matched for age and sex were used as comparators. Circulating podoplanin levels were measured in plasma using a commercial ELISA kit. The study was approved by the institutional ethics committee and all participants provided written informed consent

APL patients showed significantly higher plasma soluble podoplanin concentrations compared to non-APL AML. Using the median soluble podoplanin value as a cutoff, a higher proportion of APL patients presented elevated levels. Soluble podoplanin levels correlated with CD40L in APL cases, but not in non-APL AML patients, suggesting a possible interaction with thrombo-inflammatory activation pathways

These findings represent a proof-of-concept that measuring soluble podoplanin in plasma samples can contribute to the diagnosis of APL, while also providing novel data on the association of podoplanin with the pathogenesis of APL coagulopathy.