Minimally Differentiated Acute Myeloid Leukemia (AML-M0): Comparison of 25 Cases With Other French-American-British Subtypes

Autor: Venditti, Adriano, Del Poeta, Giovanni, Buccisano, Francesco, Tamburini, Anna, Cox, M. Christina, Stasi, Roberto, Bruno, Antonio, Aronica, Germano, Maffei, Laura, Suppo, Giovanna, Simone, Maria Domenica, Forte, Laura, Cordero, Valeria, Postorino, Massimiliano, Tufilli, Vincenza, Isacchi, Giancarlo, Masi, Mario, Papa, Giuseppe, Amadori, Sergio
Zdroj: Blood; January 1997, Vol. 89 Issue: 2 p621-629, 9p
Abstrakt: We compared the immunophenotypic and karyotypic features of 25 cases of minimally differentiated acute myeloid leukemia (AML-M0) with those of 247 cases comprising all AML French-American-British (FAB) classification. Myeloperoxidase (MPO) was detectable with a specific monoclonal antibody in all cases of AML-M0, whereas CD13 and CD33 were both negative in 4 of the 25 cases. Thus, anti-MPO reliably detects minimal myeloid differentiation in AML-M0. CD34 and terminal deoxynucleotidyl transferase (TdT) were more frequently expressed in AML-M0 (96% and 68% of the cases, respectively) than in the other FAB subsets (P < . 001 for both). By contrast, GP-170 and CD7 were less frequently expressed in AML-M0 than in FAB classes such as M1, M4, and M5 (P = .02 and .003, respectively). A total of 80% of AML-M0 cases carried lymphoid markers (including TdT), and 48% showed a coordinate positivity for two or more of them. CD2, CD5, CD10, and CD19 were expressed in a similar fashion among the different FAB groups, whereas CD4 expression was significantly more frequent in AML-M0, AML-M4, and AML-M5 (P = .014). AML-M0 was characterized by a more frequent occurrence of complex karyotypes. In addition, approximately 20% of cases had TdT positivity, complex karyotypes, and anomalies of chromosome 5 and/or 7, a pattern not observed in the other FAB subsets. Finally, 80% of anomalies of chromosome 5 and/or 7 in AML-M0 were comprised within complex karyotypes, whereas only 13% of the remaining FAB cases carried this feature. In summary, AML-M0 frequently expresses immunophenotypic and karyotypic aspects that are likely to identify a “stem cell” pattern.
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