High expression of CD74 is associated with poor prognosis and tumor immune infiltration in Acute Myeloid Leukemia.

OBJECTIVE: To investigate the expression patterns of the CD74 gene in Acute Myeloid Leukemia (LAML), its clinical prognostic significance, and its association with the tumor microenvironment (TME). METHODS: Data from public databases, including TCGA and GTEx, were integrated to analyze the differences in CD74 expression between LAML tissues and normal controls; perform subgroup analysis based on clinical and pathological characteristics; evaluate its prognostic value using survival analysis and ROC curves; elucidate its potential immune regulatory mechanisms through the CIBERSORT algorithm and functional enrichment analysis. RESULTS: CD74 was significantly overexpressed in LAML tissues, with higher expression observed in the monocyte-derived subtypes (M4-M7) and in patients with high white blood cell counts (P < 0.05). High CD74 expression is significantly associated with poor overall survival in patients with LAML(P < 0.01). Immunohistochemical analysis revealed that CD74 expression was positively correlated with the abundance of memory B cells, monocytes, and M2 macrophages, and was primarily enriched in antigen-presenting and immune response pathways. CONCLUSION: High CD74 expression is associated with poor prognosis in patients with LAML and may promote disease progression by reshaping the immune microenvironment; it holds promise as a new prognostic marker and immunotherapy target.