Complex measurements may be required to establish the prognostic impact of immunophenotypic markers in AML

Maria Concepcion García-Dabrio, Montserrat Hoyos, Salut Brunet, Mar Tormo, Josep Maria Ribera, Jordi Esteve, David Gallardo, Rafael F. Duarte, Maria Paz Queipo De Llano, Joan Bargay, Josep M. Martí-Tutusaus, Inmaculada Heras, Antoni Garcia, Olga Salamero, Anna Aventin, Quentin Lecrevisse, Alberto Orfao, Jorge Sierra, Josep F. Nomdedéu

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11 Citations (Scopus)


© 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.
Original languageEnglish
Pages (from-to)484-492
JournalAmerican Journal of Clinical Pathology
Issue number3
Publication statusPublished - 1 Jan 2015


  • AML
  • Blast cell heterogeneity
  • Mean fluorescence intensity
  • Multiparameter flow cytometry
  • Prognosis


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