Abstract OBJECTIVE: The prognostic significance of immunophenotyping in acute myeloid leukemia (AML) has been controversial. This study investigated the relationship of immunophenotypes with French-American-British (FAB) subtypes and chromosomal abnormalities and assessed the prognostic value of immunophenotyping in children with AML. METHODS: From January 1998 to May 2003, 75 children with newly diagnosed AML were enrolled on protocol AML-XH-99. Immunophenotypes were measured with the flow cytometry. According to the McAbs used, the patients were classified into five groups: panmyeloid antigens (CD13, CD33, and MPO), myeloid-lineage associated antigens (CD14, CD15), lineage-specific antigens (CD41, GlyA), progenitor-associated antigens (CD34, HLA-DR) and lymphoid-associated antigens (CD19, CD7). The probability of event-free survival (EFS) was estimated by Kaplan-Meier analysis. The distributions of EFS were compared using the log-rank test. Chi-square analysis or Fisher exact test was used to compare the differences in the distribution of biologic presenting features. A Cox proportional hazards model was used to identify independent prognostic factors. RESULTS: At least one of panmyeloid antigens CD13, CD33 and MPO was expressed in 72 patents (97.3%). Two or more panmyeloid antigens were expressed in 45 patients (60.8%). The proportion of children with AML expressing one or more of the lymphoid-associated antigens was 24.3%. Lymphoid-associated antigen CD19 was expressed by blast cells in most of FAB M2 patients. The patients with acute promyelocytic leukemia were characterized by the absence of HLA-DR and lymphoid-associated antigens CD19 and CD7. Monovariate analysis showed immunophenotypes were not related to the complete remission rate after the first induction course and the 5-year-EFS. Multivariate analysis suggested immunophenotyping had no independent prognostic value in AML.CONCLUSIONS: Immunophenotyping can not be used independently in the evaluation of risk classification in children with AML. However, it is useful in the reorganization of special types of AML.[Chin J Contemp Pediatr, 2009, 11 (4):241-245]
GU Long-Jun,TIE Li-Jun,JIANG Li-Min et al. Relationship between immunological characteristics and prognosis in children with acute myeloid leukemia[J]. 中国当代儿科杂志, 2009, 11(04): 241-245.
GU Long-Jun,TIE Li-Jun,JIANG Li-Min et al. Relationship between immunological characteristics and prognosis in children with acute myeloid leukemia[J]. CJCP, 2009, 11(04): 241-245.
[1]Pui CH, Behm FG, Crist WM. Clinical and biologic relevance of immunologic marker studies in childhood acute lymphoblastic leukemia [J]. Blood, 1993, 82(2):343-362.
[2]Moricke A, Reiter A, Zimmermann M, Gadner H, Stanulla M, Dordelmann M, et al. Risk-adjusted therapy of acute lymphoblastic leukemia can decrease treatment burden and improve survival: treatment results of 2169 unselected pediatric and adolescent patients enrolled in the trial ALL-BFM 95[J]. Blood, 2008, 111(9):4477-4489.
[3]Dakka N, Bellaoui H, Khattab M, Brahimi-Horn MC, Aoued L, Bouzid N,et al. Immunologic profile and outcome of childhood acute lymphoblastic leukemia (ALL) in Morocco[J]. J Pediatr Hematol Oncol, 2007, 29(8):574-580.
[4]Pui CH, Evans WE. Treatment of acute lymphoblastic leukemia[J]. N Engl Med, 2006, 354(2):166-178.
[5]Creutzig U, Harbott J, Sperling C, Ritter J, Zimmermann M, Loffler H, et al. Clinical significance of surface antigen expression in children with acute myeloid leukemia: results of study AML-BFM-87[J]. Blood, 1995, 86(8):3097-3108.
[6]Casasnovas RO, Slimane FK, Garand R, Faure GC, Campos L, Deneys V, et al. Immunological classification of acute myeloblastic leukemia: relevance to patient outcome[J]. Leukemia, 2003, 17(3): 515-527.
[7]Chang H, Salma F, Yi QL, Patterson B, Brien B, Minden MD. Prognostic relevance of immunophenotyping in 379 patients with acute myeloid leukemia[J]. Leuk Res, 2004, 28(1):43-48.
[8]Chang H, Yeung J, Brandwein J, Yi QL. CD7 expression predicts poor disease free survival and post-remission survival in patients with acute myeloid leukemia and normal karyotype. Leuk Res[J]. 2007, 31(2):157-262.
[9]Webber BA, Cushing MM, Li S. Prognostic significance of flow cytometric immunophenotyping in acute myeloid leukemia [J]. Int J Clin Exp Pathol, 2008, 1(2):124-133.
[10]Derolf AR, Bjorklund E, Mazur J, Bjorkholm M, Porwit A. Expression patterns of CD33 and CD15 predict outcome in patients with acute myeloid leukemia[J]. Leuk Lymphoma, 2008, 49(7):1279-1291.
[13]Smith FO, Lampkin BC, Versteeg C, Flowers DA, Dinndorf PA, Buckley JD, et al. Expression of lymphoid-associated cell surface antigens by childhood acute myeloid leukemia cells lacks prognostic significance[J]. Blood, 1992, 79(9):2415-2422.
[14]Kuerbitz SJ, Civin CI, Krischer JP, Ravindranath Y, Steuber CP, Weinstein HJ, et al. Expression of myeloid-associated and lymphoidassociated cell surface antigens in acute myeloid leukemia of childhood: A Pediatric Oncology Group Study[J]. J Clin Oncol, 1992, 10(9):1419-1429.
[15]Hurwitz CA, Raimondi SC, Head D, Krance R, Mirro J Jr, Kalwinsky DK, et al. Distinctive immunophenotypic features of t(8;21)(q22;q22) acute myeloblastic leukemia in children[J]. Blood, 1992, 80(12):3182-3188.
[16]Plesa C, Chelghoum Y, Plesa A, Elhamri M, Tigaud I, Michallet M, et al. Prognostic value of immunophenotyping in elderly patients with acute myeloid leukemia: a single-institution experience[J]. Cancer, 2008, 112(3):572-580.