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High frequency of CD34+CD38-/low immature leukemia cells is correlated with unfavorable prognosis in acute myeloid leukemia

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World Journal of Stem Cells 2017年第12期9卷 227-234页

作者： Adriana Plesa Charles Dumontet Eve Mattei Ines Tagoug Sandrine Hayette Pierre Sujobert Isabelle Tigaud Marie Pierre Pages Youcef Chelghoum Fiorenza Baracco Helene Labussierre Sophie Ducastelle etienne paubelle Franck Emmanuel Nicolini Mohamed Elhamri Lydia Campos Claudiu Plesa Stéphane Morisset Gilles Salles Yves Bertrand Mauricette Michallet Xavier Thomas Laboratory of Hematology Lyon-Sud HospitalHospices Civils de Lyon CRCL INSERM 1052/CNRS 5286 Department of Hematology Hospices Civils de Lyon Laboratory of Hematology Nord Hospital Statistical and Clinical Research Lyon-Sud HospitalHospices Civils de Lyon Department of Pediatric Hematology and BMT IHOP Lyon

AIM To evaluate the importance of the CD34+CD38-cell population when compared to the CD34+CD38+/low and CD34+CD38+/high leukemic cell sub-populations and to determine its correlations with leukemia characteristics and known prognostic factors, as well as with response to therapy and *** Two hundred bone marrow samples were obtained at diagnosis from 200 consecutive patients with newly diagnosed acute myeloid leukemia(AML) were studied between September 2008 and December 2010 at our Institution(Hematology Department, Lyon, France). The CD34/CD38 cell profile was analyzed by multiparameter flowcytometry approach using 8 C panels and FACS CANTO and Diva software(BD Bioscience).RESULTS We analyzed CD34 and CD38 expression in bone marrow samples of 200 AML patients at diagnosis, and investigated the prognostic value of the most immature CD34+CD38-population. Using a cut-off value of 1% of CD34+CD38-from total "bulk leukemic cells" we found that a high(> 1%) level of CD34+CD38-blasts at diagnosis was correlated with advanced age, adverse cytogenetics as well as with a lower rate of complete response after induction and shorter disease-free survival. In a multivariate analysis considering age, leukocytosis, the % of CD34+ blasts cells and the standardized cytogenetic and molecular risk subgroups, a percentage of CD34+CD38-leukemic cells > 1% was an independent predictor of DFS [HR = 2.8(1.02-7.73), P = 0.04] and OS [HR = 2.65(1.09-6.43), P = 0.03].CONCLUSION Taken together, these results show that a CD34/CD38 "backbone" for leukemic cell analysis by multicolour flowcytometry at diagnosis provides useful prognostic information.

关键词： CD34+CD38-/low Immunophenotyping Leukemic stem cells Acute myeloid leukemia Prognosis

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