Use of surface marker analysis to predict outcome of adult acute myeloblastic leukemia.
Use of surface marker analysis to predict outcome of adult acute myeloblastic leukemia.
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DOI：
10.1182/blood.v68.6.1232.bloodjournal6861232
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发表时间：
1986-12
期刊：
影响因子：
20.3
通讯作者：
James;-D.;Griffin;Roger;Davis;Douglas;-A.;Nelson;Frederick;-R.;Davey;Robert;-J.;Mayer;Charles;Schiffer;Ross;Mcintyre;Clara;Bloomfield
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文献类型：
--
作者：
James;-D.;Griffin;Roger;Davis;Douglas;-A.;Nelson;Frederick;-R.;Davey;Robert;-J.;Mayer;Charles;Schiffer;Ross;Mcintyre;Clara;Bloomfield
为了研究表面抗原分析在急性髓细胞白血病 (AML) 中的临床意义，使用一组 16 种单克隆抗体对 196 名 AML 患者的原始细胞进行了前瞻性分析。选择抗体来鉴定骨髓谱系（MY9、PM-81、AML-2-23、MY7、MCS-1、MY8、Mo1、MY1、MY4、Mo2）、T 细胞谱系（T101、T11）、B 细胞谱系（B1、B4）或多个谱系 [J5 (CALLA)、HLA-DR] 的分化相关抗原。对 196 例中的 161 例进行了独立形态学审查和按照法国-美国-英国 (FAB) 标准进行分类。在 195 例的原始细胞中检测到一种或多种骨髓表面抗原，而在 0% 至 2% 的病例中检测到 B 和 T 细胞标记物。当对同一患者的血液和骨髓样本进行研究时，配对样本的抗原谱之间几乎没有发现差异。单个骨髓抗原的表达频率范围为 91% (PM-81) 至 29% (Mo2)。研究发现，个体抗原的表达与多种临床参数显着相关，包括 FAB 分类、α 萘乙酸酯酶的细胞化学染色、白细胞计数以及就诊时是否存在髓外疾病。两种骨髓抗原（MY4 和 MY7）预测标准诱导化疗的完全缓解 (CR) 率较低。 MY4+ 病例（占总人口的 37%）的 CR 率为 53%，而 M4- 病例的 CR 率为 69% (P = .03)。 MY7+ 病例（占总人口的 57%）的 CR 率为 55%，而 MY7- 病例的 CR 率为 73% (P = .01)。 MY4 和 MY7 抗原表达均与患者年龄无关。还检查了抗原的配对组合。 32% 的病例表现出 [MY4-MY7-] 表型，与 82% 的 CR 率相关，而所有其他病例的 CR 率为 54% (P = .001)。三种抗原（HLA-DR、MY8、Mo1）的表达与持续完全缓解率下降相关（P 小于 0.05，中位随访时间为 19 个月）。 MY8 抗原的表达也与生存率降低相关 (P = .03)。这些结果证实了早期关于 AML 抗原异质性的报道，并表明可以鉴定具有潜在临床意义的免疫学定义的 AML 患者亚组。
In order to investigate the clinical significance of surface antigen analysis in acute myeloblastic leukemia (AML), the blasts from 196 patients with AML were analyzed prospectively with a panel of 16 monoclonal antibodies. The antibodies were selected to identify differentiation-associated antigens of either the myeloid lineage (MY9, PM-81, AML-2-23, MY7, MCS-1, MY8, Mo1, MY1, MY4, Mo2), T cell lineage (T101, T11), B cell lineage (B1, B4) or multiple lineages [J5 (CALLA), HLA-DR]. Independent morphological review and classification by French-American-British (FAB) criteria was performed in 161 of the 196 cases. One or more myeloid surface antigens were detected on the blasts of 195 cases, while B and T cell markers were detected on 0% to 2% of cases. When both blood and marrow samples were studied on the same patient, very few differences were noted between the antigenic profiles of the paired specimens. The frequency of expression of individual myeloid antigens ranged from 91% (PM-81) to 29% (Mo2). Expression of individual antigens was found to correlate significantly with several clinical parameters including FAB classification, cytochemical staining for alpha naphthyl acetate esterase, leukocyte count, and the presence of extramedullary disease at presentation. Two myeloid antigens (MY4 and MY7) predicted for a low rate of complete remission (CR) to standard induction chemotherapy. MY4+ cases (37% of the total population) had a CR rate of 53%, while M4- cases had a CR rate of 69% (P = .03). MY7+ cases (57% of the total population) had a CR rate of 55% while MY7- cases had a CR rate of 73% (P = .01). Neither MY4 nor MY7 antigen expression was correlated with patient age. Paired combinations of antigens were also examined. The [MY4- MY7-] phenotype was exhibited by 32% of all cases and was associated with an 82% CR rate while the CR rate of all other cases was 54% (P = .001). The expression of three antigens (HLA-DR, MY8, Mo1) was associated with a decreased continuous complete remission (P less than .05, median follow-up time of 19 months). Expression of MY8 antigen was also associated with decreased survival (P = .03). These results confirm earlier reports of antigenic heterogeneity in AML, and indicate that immunologically defined subgroups of AML patients which are of potential clinical significance can be identified.