ArticleClinical Medicine Insights. Oncology2026
PD-1/PD-L1-CXCR3 Coexpression and CXCR3 on Intermediate Monocytes Predict Fibrosis, Leukemic Transformation, and Survival in Egyptian Philadelphia-Negative Myeloproliferative Neoplasms.
Article in Clinical Medicine Insights. Oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background: Despite established prognostic scores, predicting disease progression in myeloproliferative neoplasms (MPNs) remains challenging, and the role of specific immune cell subsets-particularly the PD-1/PD-L1 axis-in mediating fibrosis and transformation is poorly characterized. This study aimed to investigate the prognostic utility of novel immune-inflammatory biomarkers, including PD-1/PD-L1 coexpression with C-X-C chemokine receptor type 3 (CXCR3), CXCR3 expression on monocyte subsets, and systemic indices (systemic immune-inflammation index [SII], systemic inflammation response index [SIRI]), for predicting fibrosis grade, leukemic transformation, and survival outcomes in patients with Philadelphia-negative MPNs. Methods: In a prospective case-control study, including 90 Egyptian patients with Philadelphia-negative MPNs and 90 matched controls, we quantified PD-1/PD-L1 coexpression with CXCR3 and CXCR3 expression on monocyte subsets by flow cytometry. Validation employed targeted next-generation sequencing (NGS) in the full cohort, complemented by focused mechanistic validation using bulk RNA sequencing (n = 20 primary myelofibrosis [PMF], n = 10 controls), single-cell RNA sequencing (n = 10 PMF, n = 5 controls), and targeted serum cytokine profiling (IL-6 and TGF-β; n = 90 MPN, n = 90 controls). Diagnostic/prognostic performance used receiver operating characteristic (ROC) curves, decision curve analysis, logistic/Cox regression, random forest/gradient boosting, and external validation in an independent Egyptian cohort (n = 30). Patient-reported outcomes were assessed with the Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF). Results: PD-1/CXCR3 and PD-L1/CXCR3 were elevated in patients ( Conclusion: PD-1
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