Prognostic relevance of the expression of Tdt and CD7 in 335 cases of acute myeloid leukemia
| Autor: | Antonio Bruno, G Aronica, MC Cox-Froncillo, Alessandra Battaglia, Massimiliano Postorino, B Del Moro, Amadori S, Adriano Venditti, L Forte, Anna Tamburini, AM Epiceno, V. Cordero, Francesco Buccisano, G Del Poeta, S Santinelli |
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| Předmět: |
Adult
Male endocrine system Cancer Research medicine.medical_specialty Adolescent CD34 Chromosomal translocation Antigens CD7 Biology Gastroenterology Immunophenotyping Antigen DNA Nucleotidylexotransferase hemic and lymphatic diseases Internal medicine medicine Humans Aged Aged 80 and over Chromosome Aberrations Cytogenetics Myeloid leukemia Hematology Middle Aged medicine.disease Prognosis stomatognathic diseases Leukemia Oncology Terminal deoxynucleotidyl transferase Leukemia Myeloid Karyotyping Immunology Acute Disease Female Settore MED/15 - Malattie del Sangue |
| Zdroj: | Scopus-Elsevier |
| Popis: | We have analyzed the expression of Tdt and CD7 in 335 cases of unequivocal acute myeloid leukemia (AML). Tdt was expressed in 80 (25%) of 321 evaluable cases. Twenty-six of 77 (34%) Tdt+ patients assessable for response, entered complete remission (CR) vs 121 of 209 (58%) Tdt- cases (P < 0.001). CD7 was expressed in 102 of 332 (30%) evaluable cases; 37 of 93 assessable (40%) CD7+ patients attained a CR as compared to 114/204 (56%) CD7- (P = 0.013). Duration of survival was significantly shorter for patients with CD7+ or Tdt+ AML (P = 0.006 and 0.001, respectively). In a multivariate analysis, Tdt was found to significantly adverse achievement of CR (P = 0.018), while CD7 affected duration of CR (P = 0.037). Overall the expression of either Tdt or CD7 correlated with a relatively high expression of CD34 (P < 0.001), GP-170 (P = 0.003), lymphoid antigens (LyAg) (P < 0.001), t(9;22) or anomalies of chromosome 5/7 (P < 0.001). Finally, we pooled the patients into four phenotypic classes, according to the presence of Tdt, CD7 or both: [Tdt-CD7-], [Tdt+CD7-], [Tdt-CD7+] and [Tdt+CD7+]. The category [Tdt+CD7+] was characterized by a more unfavorable outcome as suggested by a lower rate of CR (P < 0.001) and a shorter duration of survival as compared to cases [Tdt-CD7-], [Tdt+CD7-] and [Tdt-CD7+] (P = 0.002). This figure is consistent with the frequent convergence in the subset [Tdt+CD7+] of GP-170 positivity (P = 0.003), translocation t(9;22), anomalies of chromosome 5 and/or 7 (P < 0.001) and signs of lineage infidelity (deviant expression of lymphoid antigens) (P < 0.001). We conclude that the expression of Tdt or CD7 is associated with an unfavorable outcome and that the combination of both defines a clinical subset with a poorer prognosis due to the significantly higher association with MDR phenotype, and 'poor prognostic' chromosomal abnormalities. |
| Databáze: | OpenAIRE |
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