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Immunophenotype of acute myeloid leukemia with NPM mutations: Prognostic impact of the leukemic compartment size
- Source :
- LEUKEMIA RESEARCH, r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau, instname
- Publication Year :
- 2011
- Publisher :
- Elsevier BV, 2011.
-
Abstract
- NPM mutations are the most common genetic abnormalities found in non-promyelocytic AML. NPM-positive patients usually show a normal karyotype, a peculiar morphologic appearance with frequent monocytic traits and good prognosis in the absence of an associated FLT3 mutation. This report describes the immunophenotypic and genetic characteristics of a consecutive series of NPM-mutated de novo AML patients enroled in the CETLAM trial. Eighty-three patients were included in the study. Complete immunophenotype was obtained using multiparametric flow cytometry. Associated genetic lesions (FLT3, MLL, CEBPA and WT1 mutations) were studied by standardized methods. Real-time PCR was employed to assess the minimal residual status. The most common pattern was CD34-CD15+ and HLA-DR+. Small CD34 populations with immunophenotypic aberrations (CD15 and CD19 coexpression, abnormal SSC) were detected even in CD34 negative samples. Nearly all cases expressed CD33 (strong positivity), CD13 and CD117, and all were CD123+. The stem cell marker CD110 was also positive in most cases. Biologic parameters such as a high percentage of intermediate CD45+ (blast gate) (> 75% nucleated cells), CD123+ and FLT3-ITD mutations were associated with a poor outcome. Quantitative PCR positivity had no prognostic impact either after induction or at the end of chemotherapy. Only PCR positivity (greater than 10 copies) detected in patients in haematological remission was associated with an increased relapse rate. Further studies are required to determine whether the degree of leukemic stem cell expansion (CD45 + CD123 + cells) increases the risk of acquisition of FLT3-ITD and/or provides selective advantages. (C) 2010 Elsevier Ltd. All rights reserved.
- Subjects :
- Adult
Male
Cancer Research
Pathology
medicine.medical_specialty
Genes, Wilms Tumor
Myeloid
CD33
Kaplan-Meier Estimate
Biology
Stem cell marker
Immunophenotyping
Young Adult
Antigens, CD
CEBPA
medicine
Humans
Flow cytometry
Aged
Acute leukemias
Reverse Transcriptase Polymerase Chain Reaction
CD117
Nuclear Proteins
Myeloid leukemia
Histone-Lysine N-Methyltransferase
Hematology
Middle Aged
Flow Cytometry
Prognosis
medicine.disease
Leukemia, Myeloid, Acute
Leukemia
medicine.anatomical_structure
fms-Like Tyrosine Kinase 3
NPM mutations
Oncology
Mutation
CCAAT-Enhancer-Binding Proteins
Cancer research
biology.protein
Female
Nucleophosmin
Immunophenotype
Myeloid-Lymphoid Leukemia Protein
Subjects
Details
- ISSN :
- 01452126
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Leukemia Research
- Accession number :
- edsair.doi.dedup.....a3cd05d3d577e77ba9e476f9761e7453
- Full Text :
- https://doi.org/10.1016/j.leukres.2010.05.015