Blast vacuolization in AML patients indicates adverse-risk AML and is associated with impaired survival after intensive induction chemotherapy
Blast vacuolization in AML patients indicates adverse-risk AML and is associated with impaired survival after intensive induction chemotherapy
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DOI：
10.1371/journal.pone.0223013
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发表时间：
2019-09-30
期刊：
影响因子：
3.7
通讯作者：
Brandts, Christian
中科院分区：
文献类型：
--
作者：
Ballo, Olivier;Stratmann, Jan;Brandts, Christian
空泡化是急性髓性白血病（AML）细胞中常见的形态学特征。亚细胞起源和生物学功能以及预后影响目前尚不清楚。本研究的目的是评估空泡化是否与AML临床相关特征相关。材料与方法分析2011年1月至2013年8月在法兰克福大学医院诊断为AML的患者骨髓涂片的细胞空泡化及其与AML临床相关特征的相关性。进一步分析接受标准诱导化疗的患者的分子和细胞遗传学特征以及治疗反应和生存期。结果100例接受标准诱导化疗的AML患者中有14例出现胚泡化。根据欧洲白血病网（European LeukemiaNet）的风险分层，空泡化阳性与CD15阳性免疫表型相关，并与高风险AML的较高发病率相关。急性髓细胞白血病患者在标准诱导化疗后细胞清除率较差，生存期较差。总之，我们的研究结果表明，空泡化可以很容易地在髓性白血病原细胞中确定，并且可能是预测AML风险群体以及早期治疗反应率和生存率的有用生物标志物。
IntroductionVacuolization is a frequently found morphological feature in acute myeloid leukemia (AML) blasts. Subcellular origin and biological function as well as prognostic impact are currently unknown. The aim of this study was to evaluate whether vacuolization correlates with clinically relevant AML features.Materials & methodsBone marrow smears of patients diagnosed with AML at the University Hospital Frankfurt between January 2011 and August 2013 were analyzed for blast vacuolization and correlated with clinically relevant AML features. Patients undergoing standard induction chemotherapy were further analyzed for molecular and cytogenetic features as well as treatment response and survival.Results14 of 100 patients diagnosed with AML receiving standard induction chemotherapy had evidence of blast vacuolization. Positivity for vacuolization correlated with a CD15 positive immunophenotype and with a higher incidence of high-risk AML according to the European LeukemiaNet risk stratification. AML patients with blast vacuolization had a poor blast clearance after standard induction chemotherapy and poor survival.DiscussionIn conclusion, our findings demonstrate that vacuolization can easily be determined in myeloid leukemia blasts and may be a useful biomarker to predict AML risk groups as well as early treatment response rates and survival.