Relation of serum SEMA3A and SEMA4D with risk stratification and prognosis in pediatric patients with acute lymphoblastic leukemia

TANG Changchao; ZUO Feng; BAI Hua; WEI Xueli

doi:10.3969/j.issn.1674-3806.2025.09.12

Abstract：Objective To explore the relation of serum semaphorin 3A(SEMA3A)and semaphorin 4D(SEMA4D)with risk stratification and prognosis in pediatric patients with acute lymphoblastic leukemia(ALL).Methods A total of 128 pediatric patients with ALL who were admitted to General Hospital of Ningxia Medical University from March 2019 to March 2023 were recruited.According to the risk stratification of ALL in these pediatric patients,they were divided into low-risk group(31 patients),medium-risk group(62 patients)and high-risk group(35 patients).The levels of serum SEMA3A and SEMA4D were measured using enzyme-linked immunosorbent assay(ELISA).According to the prognosis of the pediatric patients at 12 months after treatment,they were divided into poor prognosis group(26 patients)and good prognosis group(102 patients).The clinical data were compared between the two groups.Spearman rank correlation was used to analyze the correlation of the levels of SEMA3A and SEMA4D with the risk stratification of the ALL pediatric patients.Multivariate logistic regression was used to analyze the influencing factors of poor prognosis in the pediatric patients with ALL.Results The serum SEMA3A levels in the low-risk group,the medium-risk group and the high-risk group decreased successively,while their serum SEMA4D levels increased successively,with statistically significant differences(P＜0.05).The results of Spearman rank correlation analysis showed that the SEMA3A level was negatively correlated with the risk stratification of ALL in the pediatric patients(r,=-0.689,P＜0.001),while the SEMA4D level was positively correlated with the risk stratification of ALL in the pediatric patients(r,=0.452,P＜0.001).Compared with the good prognosis group,the poor prognosis group was older,and had higher levels of white blood cell count(WBC)and SEMA4D,and lower levels of SEMA3A,with statistically significant differences(P＜0.05).There were statistically differences in immunoclassification and risk stratification between the two gropus(P＜0.05).The results of multivariate logistic regression analysis showed that older age,higher WBC level,higher SEMA4D level,immunoclassification of T-ALL and high-risk types in risk stratification were independent risk factors for poor prognosis in the pediatric patients with ALL(P＜0.05),while higher SEMA3A level was an independent protective factor for poor prognosis in the pediatric patients with ALL(P＜0.05).Conclusion The levels of serum SEMA3A and SEMA4D in pediatric patients with ALL are closely related to risk stratification and prognosis.A decrease in SEMA3A levels and an increase in SEMA4D levels can raise the risk of poor prognosis.