TY - JOUR
T1 - Complex measurements may be required to establish the prognostic impact of immunophenotypic markers in AML
AU - García-Dabrio, Maria Concepcion
AU - Hoyos, Montserrat
AU - Brunet, Salut
AU - Tormo, Mar
AU - Ribera, Josep Maria
AU - Esteve, Jordi
AU - Gallardo, David
AU - Duarte, Rafael F.
AU - De Llano, Maria Paz Queipo
AU - Bargay, Joan
AU - Martí-Tutusaus, Josep M.
AU - Heras, Inmaculada
AU - Garcia, Antoni
AU - Salamero, Olga
AU - Aventin, Anna
AU - Lecrevisse, Quentin
AU - Orfao, Alberto
AU - Sierra, Jorge
AU - Nomdedéu, Josep F.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - © 2015 American Society for Clinical Pathology. Objectives: The prognostic impact of immunophenotypic markers in acute myeloid leukemia (AML) is controversial. Methods: We retrospectively analyzed the value of CD34, CD117, CD7, and CD123 expression in a consecutive series of 592 adult patients with de novo AML. Results: CD34+ measured as a percentage (≥2.88%) and CD34 mean fluorescence intensity (MFI) (≥146.79, arbitrary units [AU]) expression had a prognostic impact in terms of overall survival (OS; P = .005, P = .003), leukemia-free survival (LFS; P = .011, P <.001), and cumulative incidence of relapse (CIR; P = .014, P =. 001). The percentage of CD117+ cells (61.29%) was associated with shorter LFS (P =. 043), and CD117 MFI (≥284.01 AU) was associated with a shorter OS (P =. 033) and LFS (P =. 028). In the multivariate analysis, high CD34 MFI retained the independent value as predictor of LFS and CIR (P =. 012; hazard ratio [HR], 1.59; 95% confidence interval [CI], 1.11- 2.28 and P =. 045; HR, 1.58; 95% CI, 1.01-2.46). Conclusions: CD34 positivity threshold with prognostic relevance is low (3% positive cells). Immunophenotypic findings in AML probably could only be fully exploited after a complex analysis that takes into account unconventional thresholds and the MFI.
AB - © 2015 American Society for Clinical Pathology. Objectives: The prognostic impact of immunophenotypic markers in acute myeloid leukemia (AML) is controversial. Methods: We retrospectively analyzed the value of CD34, CD117, CD7, and CD123 expression in a consecutive series of 592 adult patients with de novo AML. Results: CD34+ measured as a percentage (≥2.88%) and CD34 mean fluorescence intensity (MFI) (≥146.79, arbitrary units [AU]) expression had a prognostic impact in terms of overall survival (OS; P = .005, P = .003), leukemia-free survival (LFS; P = .011, P <.001), and cumulative incidence of relapse (CIR; P = .014, P =. 001). The percentage of CD117+ cells (61.29%) was associated with shorter LFS (P =. 043), and CD117 MFI (≥284.01 AU) was associated with a shorter OS (P =. 033) and LFS (P =. 028). In the multivariate analysis, high CD34 MFI retained the independent value as predictor of LFS and CIR (P =. 012; hazard ratio [HR], 1.59; 95% confidence interval [CI], 1.11- 2.28 and P =. 045; HR, 1.58; 95% CI, 1.01-2.46). Conclusions: CD34 positivity threshold with prognostic relevance is low (3% positive cells). Immunophenotypic findings in AML probably could only be fully exploited after a complex analysis that takes into account unconventional thresholds and the MFI.
KW - AML
KW - Blast cell heterogeneity
KW - Mean fluorescence intensity
KW - Multiparameter flow cytometry
KW - Prognosis
U2 - 10.1309/AJCPRL6XSVFMLH9V
DO - 10.1309/AJCPRL6XSVFMLH9V
M3 - Article
SN - 0002-9173
VL - 144
SP - 484
EP - 492
JO - American Journal of Clinical Pathology
JF - American Journal of Clinical Pathology
IS - 3
ER -