CD34-Negative is Highly Associated with T (15;17), T (V; 11q23) and theNPM1-Mutation Subtypes in 343 Newly Diagnosed Patients with Acute MyeloidLeukemia
CD34-Negative is Highly Associated with T (15;17), T (V; 11q23) and theNPM1-Mutation Subtypes in 343 Newly Diagnosed Patients with Acute MyeloidLeukemia
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DOI：
10.4172/2167-7700.1000200
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发表时间：
2016-05
期刊：
影响因子：
3.3
通讯作者：
Honghu Zhu;Yan-rong Liu;Yazhen Qin
中科院分区：
文献类型：
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作者：
Honghu Zhu;Yan-rong Liu;Yazhen Qin
目的：近年来研究发现，急性髓系白血病（AML）的几种细胞遗传学或分子亚型与CD 34阳性相关。然而，AML中CD 34阴性的状态需要探索。在这项研究中，我们的目的是探讨CD 34阴性患者的患病率及其与分子遗传学状态在一个大的连续AML队列。方法：对我中心343例初治AML患者的临床资料进行回顾性分析。通过流式细胞术检测CD 34表达，当其在少于20%的骨髓原始细胞中表达时，认为其为阴性。用G显带技术进行核型分析。用PCR方法检测白血病融合基因和突变基因。结果：343例患者中143例（41.7%）CD 34阴性。根据FAB分类，M3和M5亚型中CD 34阴性患者的百分比较高（分别为100%和70%），而M2和M4亚型中的百分比较低（分别为30.3%和21.2%）。根据WHO分类，t（15; 17）、t（1（v; 11 q23），和NPM 1突变（100%，n=37; 100%，n=7;和81.7%，n=71）和较低的t（8; AML伴MDS相关改变（分别为8.6%，n=35和5.0%，n=20）。t（15; 17）、t（v; 11 q23）和NPM 1突变的患者占CD 34阴性人群的71.3%（102/143）和CD 34阳性人群的6.5%（13/200）（p<0.0001）。CD 34阴性表型与单独根据细胞遗传学以及结合细胞遗传学和分子分析的风险亚组相关（分别为p=0.025和p<0.0001）。CD 34阴性对t（15;17）、t（v; 11 q23）和NPM 1突变的敏感性、特异性、阳性预测值和阴性预测值分别为88.7%、82.0%、71.3%和93.5%。结论：初治AML患者中CD 34阴性者较多。AML患者CD 34阴性与t（15;17）、t（v; 11 q23）及NPM 1突变高度相关，为AML患者免疫表型与分子遗传学的相关性提供了证据。
Objective: Recent reports found that several cytogenetic or molecular subtypes of acute myeloid leukemia (AML) are associated with CD34-positive. However, the status of CD34-negative in AML needs to be explored. In this study, we aimed to explore the prevalence of the CD34-negative patients and its association with molecular genetics status in a large consecutive AML cohort. Methods: A group of 343 consecutive newly diagnosed AML patients was retrospectively analyzed in our center. CD34 expression was detected by flow cytometry and considered negative when it was expressed in less than 20% of the bone marrow blast cells. The karyotype was analyzed by the G-banding technique. Leukemic fusion genes and mutated genes were detected by PCR method. Results: CD34-negative was found in 143 (41.7%) of the 343 patients. According to FAB classification, the percentages of CD34-negative patients were higher in the M3 and M5 (100% and 70%, respectively) and lower in the M2 and M4 subtypes (30.3% and 21.2%, respectively). According to the WHO classification, the percentage of CD34-negative patients was higher in those with t(15; 17), t(v; 11q23), and the NPM1-mutation (100%, n=37; 100%, n=7; and 81.7%, n=71, respectively) and lower in those with t(8;21) and AML with MDS-related changes (8.6%, n=35 and 5.0%, n=20, respectively). The patients with t(15; 17), t(v; 11q23) and the NPM1-mutation consisted of 71.3% (102/143) of the CD34-negative population and 6.5% (13/200) of the CD34-positive population (p<0.0001). A CD34-negative phenotype was associated with risk subgroups according to cytogenetics alone and when combining cytogenetics and molecular analysis (p=0.025 and p<0.0001, respectively). The sensitivity, specificity, positivepredictive value and negative-predictive value of the CD34-negative to t (15;17), t (v; 11q23) and the NPM1-mutation were 88.7%, 82.0%, 71.3% and 93.5%, respectively. Conclusions: The prevalence of the CD34-negative patients is very common in newly diagnosed AML. CD34- negative is highly associated with t (15;17), t(v; 11q23) and the NPM1-mutation in AML patients, which provide the evidence about the association of immunophenotype and molecular genetics.