The reliability and specificity of c-kit for the diagnosis of acute myeloid leukemias and undifferentiated leukemias
The reliability and specificity of c-kit for the diagnosis of acute myeloid leukemias and undifferentiated leukemias
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DOI：
10.1182/blood.v92.2.596.414k05_596_599
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发表时间：
1998-07-15
期刊：
影响因子：
20.3
通讯作者：
van't Veer, MB
中科院分区：
文献类型：
--
作者：
Bene, MC;Bernier, M;van't Veer, MB
我们记录了1,937例儿童和成人新发急性白血病病例中c-kit(CD117)表达的结果，这些病例由五个欧洲中心诊断。根据欧洲白血病免疫分类组织(EGIL)的说法，所有病例的形态、细胞化学和免疫学特征都很好。急性髓系白血病(AML)1103例，急性淋巴细胞白血病(ALL)819例，双表型急性白血病(BAL)11例，未分化白血病(AUL)4例。无论是法美英(FAB)亚型，C-KIT在741例(67%)AML中表达，占BAL全部4例AUL的1/3，但仅在34例(4%)AML中表达。少数c-kit(+)ALL病例分为T细胞系(2/3)，主要为原T-ALL或T-L，B系(1/3)，其中62%的细胞同时表达其他髓系标志(CD_(13)、CD_(33))。在成人组和儿童组中，c-kit(+)AML的频率没有差异，或者所有病例的年龄相似。我们的研究结果表明，c-kit是检测致力于髓系白血病细胞的可靠和特异的标志物，因此应纳入急性白血病诊断的常规基础上，以证明原始细胞的髓系承诺，在目前应用于BAL诊断的系统中，c-kit的表达应高于至少1分，因为其髓系特异性大于CD13和CD33。在ALL和AUL中的发现表明，c-kit确定了一种亚群的病例，可能对应于起源于早期前胸腺细胞和/或早期造血细胞的白血病，两者都能够分化为淋巴和髓系途径。(C)1998年由美国血液病学会主办。
We document findings on c-kit (CD117) expression in 1,937 pediatric and adult de novo acute leukemia cases, diagnosed in five single European centers. All cases were well characterized as to the morphologic, cytochemical, and immunologic features, according to the European Group for the Immunological Classification of Leukemias (EGIL). The cases included 1,103 acute myeloid leukemia (AML), 819 acute lymphoblastic leukemia (ALL), 11 biphenotypic acute leukemia (BAL), and 4 undifferentiated (AUL). c-kit was expressed in 741 (67%) AML cases, regardless of the French-American-British (FAB) subtype, one third of BAL all four AUL, but only in 34 (4%) of ALL cases. The minority of c-kit(+) ALL cases were classified as: T-cell lineage (two thirds), mainly pro-T-ALL or T-l, and B lineage (one third); cells from 62% of these ALL cases coexpressed other myeloid markers (CD13, CD33, or both). There were no differences in the frequency of c-kit(+) AML or ALL cases according to age being similar in the adult and pediatric groups. Our findings demonstrate that c-kit is a reliable and specific marker to detect leukemia cells committed to the myeloid lineage, and therefore should be included in a routine basis for the diagnosis of acute leukemias to demonstrate myeloid commitment of the blasts, c-kit expression should score higher, at least one point, in the system currently applied to the diagnosis of BAL, as its myeloid specificity is greater than CD13 and CD33. Findings in ALL and AUL suggest that c-kit identifies a subgroup of cases, which may correspond to leukemias either arising from early prothymocytes and/or early hematopoietic cells, both able to differentiate to the lymphoid and myeloid pathways. (C) 1998 by The American Society of Hematology.