[Prognostic Significance of the Percentage of Blasts with CD34 + /CD38 low/- /CD123 + Phenotype in Acute Myeloid Leukemias].

Objective: To investigate the percentage of blasts with the CD34 ⁺ /CD38 ^low/- /CD123 ⁺ phenotype in de novo acute myeloid leukemia (AML) patients and analyse its correlation with prognosis.
Methods: The percentage of CD34 ⁺ /CD38 ^low/- /CD123 ⁺ cells in the blast population of 148 newly diagnosed patients with AML was determined by using flow cytometry and its correlation with complete response, disease-free survival and overall survival were evaluated.
Results: The median percentage of CD34 ⁺ /CD38 ^low/- /CD123 ⁺ cells in newly diagnosed patients was 2.8% (ranged from 0.01 to 67%). The high expression of CD34 ⁺ /CD38 ^low/- /CD123 ⁺ in AML patients positively correlated with the NPM1 wild-type (χ ² =5.194,P<0.05), but did not relate with the positive FLT3-ITD mutations (χ ² =0.418,P>0.05). Further multivariable analysis showed that the higher expression of the CD34 ⁺ /CD38 ^low/- /CD123 ⁺ was associated with lower complete remission (P<0.05), worse disease-free survival(P<0.01) and shorter overall survival(P<0.01) in AML patients.
Conclusion: The percentage of CD34 ⁺ /CD38 ^low/- /CD123 ⁺ cells at diagnosis significantly correlates with the response to treatment and survival. This prognostic marker may be used to rapidly identify the risk of treatment failure in clinical practice.