PROGNOSTIC IMPORTANCE OF IMMUNOPHENOTYPING IN ADULTS WITH ACUTE MYELOCYTIC-LEUKEMIA - THE SIGNIFICANCE OF THE STEM-CELL GLYCOPROTEIN CD34 (MY10)
PROGNOSTIC IMPORTANCE OF IMMUNOPHENOTYPING IN ADULTS WITH ACUTE MYELOCYTIC-LEUKEMIA - THE SIGNIFICANCE OF THE STEM-CELL GLYCOPROTEIN CD34 (MY10)
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DOI：
10.1111/j.1365-2141.1990.tb06365.x
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发表时间：
1990-11-01
影响因子：
6.5
通讯作者：
CIVIN, CI
中科院分区：
文献类型：
--
作者：
GELLER, RB;ZAHURAK, M;CIVIN, CI
一系列的23个单克隆抗体与正常的淋巴细胞和髓系细胞在不同阶段的分化被用来表征96例成人急性髓细胞白血病（AML），集中在可能的作用，这些抗原的表达可能有预测反应的强化化疗。只有CD 34（P = 0.008）和HLA-DR（P = 0.035）的表达在预测治疗反应方面有意义;白血病细胞表达CD 34（My 10）的患者完全缓解（CR）率为59%，而原始细胞不表达抗原的患者为87%。在预测CR的多变量分析中，CD 34表达、疾病类别（原发AML vs继发性ASML [SAML]或既往血液病史[AHD]）和WBC是显著的协变量。调整疾病类别和WBC后，CD 34阳性AML患者进入CR的可能性是不表达抗原的疾病患者的三分之一（P = 0.066）。对58例表达CD 34的白血病患者和33例CD 34阴性患者的临床特征进行比较，发现CD 33阳性AML患者的SAML和AHD发生率较高，诊断时WBC较低，涉及5号和/或7号染色体的染色体异常发生率较高。其中28例患者在复发时也进行了免疫表型分析。表现为CD 34阴性疾病的患者。此外，有患者表现为CD 34阴性AML，然后复发为CD 34阳性AML。这些结果表明，强化的细胞减灭治疗对CD 34阳性AML无效。患有CD 34阳性AML的患者可能需要不同的治疗方法才能完全根除疾病。
A series of 23 monoclonal antibodies reactive with normal lymphoid and myeloid cells at various stages of differentiation were used to characterize 96 adult patients with acute myelocytic leukaemia (AML), concentrating on the possible role the expression of these antigens may have in predicting response to intensive chemotherapy. Only the expression of CD34 (P = 0.008) and HLA-DR (P = 0.035) was significant in predicting response to therapy; patients with leukaemic cells expressing CD34 (My10) had a complete remission (CR) rate of 59% compared to 87% for those with blasts not expressing the antigen. In a multivariate analysis predicting for CR, the expression of CD34, the disease category (de novo AML versus secondary ASML [SAML] or a history of antecedent haematological disorder [AHD]), and WBC were significant covariates. Adjusting for disease category and WBC, patients with CD34-positive AML were one-third as likely to enter CR as with those with disease not expressing the antigen (P = 0.066). Comparison of clinical characteristics between the 58 patients whose leukaemia expressed CD34 and the 33 which were CD34-negative found that patients with CD33-positive AML had a higher incidence of SAML and AHD, a lower WBC at diagnosis, and a more frequent incidence of chromosomal abnormalities involving chromosomes 5 and/or 7. Twenty-eight of these patients also had immunophenotyping performed at relapse. Patients who presented with CD34-negative disease. In addition, there were patients presenting with CD34-negative AML and then relapsing with CD34-positive AML. These results suggest that intensive cytoreductive therapy is ineffective against CD34-positive AML. Patients who present with CD34-positive AML may required different therapeutic approaches to completely eradicate their disease.