Abstract
Occurrence of aberrant phenotypes in childhood and adult acute leukemia (AL) differs considerably in independent studies and their association with prognostic factors is still controversial. In the present study, 214 patients with AL (106 children and 108 adults) were evaluated for the aberrant expression of CD33 in ALL (B cell and T cell) and CD3, CD5, CD7, and CD19 in AML. In B-ALL, aberrant expression of CD33 was found in 39 and 23% cases of adult and children, respectively. In T-ALL, CD33 was seen in 33% cases of adults while in children CD33 was not observed. In AML, aberrant expression of CD19 was expressed in 52 and 32% while CD7 was expressed in 14 and 15% cases of childhood and adult AML, respectively. Among FAB subtypes, aberrant expression of CD19 and CD7 was more commonly seen in M5 subtype. One adult patient (AML-M5) showed expression of CD3, CD5, and CD19. In summary, aberrant phenotype was commonly seen in adults than childhood B-ALL while in AML, aberrant phenotype was more common in children than adults. CD19 was most commonly expressed antigen followed by CD7 in both childhood and adult AML. Interestingly, aberrant phenotype was not found in childhood T-ALL; however, it was seen in 33% cases of adults. We did not find any association of aberrant phenotype with adverse prognosis factors, CD34 marker, and clinical outcome except the absence of auer rod which was found to be significantly associated with aberrant phenotype of childhood AML (P = 0.01).
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References
Reading CL, Estey EH, Huh YO et al (1993) Expression of unusual immunophenotype combinations in acute myelogenous leukemia. Blood 81(11):3083–3090
Macedo A, Orfao A, Vidriales MB et al (1995) Characterization of aberrant phenotypes in acute myeloblastic leukemia. Ann Hematol 70(4):189–194
Khalidi HS, Medeiros LJ, Chang KL, Brynes RK, Slovak ML, Arber DA (1998) The immunophenotype of adult acute myeloid leukemia: high frequency of lymphoid antigen expression and comparison of immunophenotype, French-American-British classification and karyotypic abnormalities. Am J Clin Pathol 109(2):211–220
Bahia DM, Yamamoto M, Chauffaille Mde L et al (2001) Aberrant phenotypes in acute myeloid leukemia: a high frequency and its clinical significance. Haematologica 86(8):801–806
Legrand O, Perrot JY, Baudard M et al (2000) The immunophenotype of 177 adults with acute myeloid leukemia: proposal of a prognostic score. Blood 96(3):870–877
Cruse JM, Lewis RE, Pierce S, Lam J, Tadros Y (2005) Aberrant expression of CD7, CD56, and CD79a antigens in acute myeloid leukemias. Exp Mol Pathol 79(1):39–41
El-Sissy AH, El-Mashari MA, Bassuni WY, El-Swaayed AF (2006) Aberrant lymphoid antigen expression in acute myeloid leukemia in Saudi Arabia. J Egypt Natl Cancer Inst 18(3):244–249
Drexler HG, Thiel E, Ludwig WD (1991) Review of the incidence and clinical relevance of myeloid antigen-positive acute lymphoblastic leukemia. Leukemia 5(8):637–645
Boldt DH, Kopecky KJ, Head D, Gehly G, Radich JP, Appelbaum FR (1994) Expression of myeloid antigens by blast cells in acute lymphoblastic leukemia of adults. The Southwest Oncology Group experience. Leukemia 8(12):2118–2126
Preti HA, Huh YO, O’Brien SM et al (1995) Myeloid markers in adult acute lymphocytic leukemia. Correlations with patient and disease characteristics and with prognosis. Cancer 76(9):1564–1570
Shen HQ, Tang YM, Yang SL et al (2003) Immunophenotyping of 222 children with acute leukemia by multi-color flow cytometry. Zhonghua Er Ke Za Zhi 41(5):334–337
Vitale A, Guarini A, Ariola C et al (2007) Absence of prognostic impact of CD13 and/or CD33 antigen expression in adult acute lymphoblastic leukemia. Results of the GIMEMA ALL 0496 trial. Haematologica 92(3):342–348
Drexler HG, Thiel E, Ludwig WD (1993) Acute myeloid leukemias expressing lymphoid-associated antigens: diagnostic incidence and prognostic significance. Leukemia 7(4):489–498
Firat H, Favier R, Adam M et al (2001) Determination of myeloid antigen expression on childhood acute lymphoblastic leukaemia cells: discrepancies using different monoclonal antibody clones. Leuk Lymphoma 42(1–2):75–82
Smith LJ, Curtis JE, Messner HA, Senn JS, Furthmayr H, McCulloch EA (1983) Lineage infidelity in acute leukemia. Blood 61(6):1138–1145
Cross AH, Goorha RM, Nuss R et al (1988) Acute myeloid leukemia with T-lymphoid features: a distinct biologic and clinical entity. Blood 72(2):579–587
Ball ED, Davis RB, Griffin JD et al (1991) Prognostic value of lymphocyte surface markers in acute myeloid leukemia. Blood 77(10):2242–2250
Smith FO, Lampkin BC, Versteeg C et al (1992) Expression of lymphoid-associated cell surface antigens by childhood acute myeloid leukemia cells lacks prognostic significance. Blood 79(9):2415–2422
Kuerbitz SJ, Civin CI, Krischer JP et al (1992) Expression of myeloid-associated and lymphoid-associated cell-surface antigens in acute myeloid leukemia of childhood: a Pediatric Oncology Group study. J Clin Oncol 10(9):1419–1429
Sobol RE, Mick R, Royston I et al (1987) Clinical importance of myeloid antigen expression in adult acute lymphoblastic leukemia. N Engl J Med 316(18):1111–1117
Wiersma SR, Ortega J, Sobel E, Weinberg KI (1991) Clinical importance of myeloid-antigen expression in acute lymphoblastic leukemia of childhood. N Engl J Med 324(12):800–808
Reiter A, Schrappe M, Ludwig WD et al (1992) Favorable outcome of B-cell acute lymphoblastic leukemia in childhood: a report of three consecutive studies of the BFM group. Blood 80(10):2471–2478
Pui CH, Behm FG, Crist WM (1993) Clinical and biologic relevance of immunologic marker studies in childhood acute lymphoblastic leukemia. Blood 82(2):343–362
Uckun FM, Sather HN, Gaynon PS et al (1997) Clinical features and treatment outcome of children with myeloid antigen positive acute lymphoblastic leukemia: a report from the Children’s Cancer Group. Blood 90(1):28–35
Bhushan B, Ahuja D, Verma S, Saluja S, Siddiqui S, Kapur S (2007) Relation of cell viability and apoptosis with clinical remission following induction chemotherapy in ALL and AML. J Exp Clin Cancer Res 26(3):313–321
Kawai S, Zha Z, Yamamoto Y, Shimizu H, Fujimoto T (1995) Clinical significance of childhood acute myeloid leukemias expressing lymphoid-associated antigens. Pediatr Hematol Oncol 12(5):463–469
Zhu H, Niu T, Meng W, Xu C, Lei S (2002) Immunophenotype of acute leukemia and its clinical significance. Hua Xi Yi Ke Da Xue Xue Bao 33(1):118–120
Lo Coco F, De Rossi G, Pasqualetti D et al (1989) CD7 positive acute myeloid leukaemia: a subtype associated with cell immaturity. Br J Haematol 73(4):480–485
Zutter MM, Martin PJ, Hanke D, Kidd PG (1990) CD7+ acute non-lymphocytic leukemia: evidence for an early multipotential progenitor. Leuk Res 14(1):23–26
Jensen AW, Hokland M, Jorgensen H, Justesen J, Ellegaard J, Hokland P (1991) Solitary expression of CD7 among T-cell antigens in acute myeloid leukemia: identification of a group of patients with similar T-cell receptor beta and delta rearrangements and course of disease suggestive of poor prognosis. Blood 78(5):1292–1300
Kita K, Miwa H, Nakase K et al (1993) Clinical importance of CD7 expression in acute myelocytic leukemia. The Japan Cooperative Group of Leukemia/Lymphoma. Blood 81(9):2399–2405
Del Poeta G, Stasi R, Venditti A et al (1994) Prognostic value of cell marker analysis in de novo acute myeloid leukemia. Leukemia 8(3):388–394
Saxena A, Sheridan DP, Card RT, McPeek AM, Mewdell CC, Skinnider LF (1998) Biologic and clinical significance of CD7 expression in acute myeloid leukemia. Am J Hematol 58(4):278–284
Lewis RE, Cruse JM, Sanders CM, Webb RN, Suggs JL (2007) Aberrant expression of T-cell markers in acute myeloid leukemia. Exp Mol Pathol 83(3):462–463
Kita K, Nakase K, Miwa H et al (1992) Phenotypical characteristics of acute myelocytic leukemia associated with the t(8;21)(q22;q22) chromosomal abnormality: frequent expression of immature B-cell antigen CD19 together with stem cell antigen CD34. Blood 80(2):470–477
Thalhammer-Scherrer R, Mitterbauer G, Simonitsch I et al (2002) The immunophenotype of 325 adult acute leukemias: relationship to morphologic and molecular classification and proposal for a minimal screening program highly predictive for lineage discrimination. Am J Clin Pathol 117(3):380–389
Suggs JL, Cruse JM, Lewis RE (2007) Aberrant myeloid marker expression in precursor B-cell and T-cell leukemias. Exp Mol Pathol 83(3):471–473
Ng SM, Ariffin WA, Lin HP, Chan LL, Chin YM (2000) Clinical features and treatment outcome of children with myeloid antigen coexpression in B-lineage acute lymphoblastic leukemia: a study of 151 Malaysian children. J Trop Pediatr 46(2):73–78
Pui CH, Raimondi SC, Head DR et al (1991) Characterization of childhood acute leukemia with multiple myeloid and lymphoid markers at diagnosis and at relapse. Blood 78(5):1327–1337
Zheng J, Wang X, Hu Y et al (2008) A correlation study of immunophenotypic, cytogenetic, and clinical features of 180 AML patients in China. Cytometry B Clin Cytom 74(1):25–29
Yenerel MN, Atamer T, Yavuz AS et al (2002) Myeloid antigen expression provides favorable outcome in patients with adult acute lymphoblastic leukemia: a single-center study. Ann Hematol 81(9):498–503
Creutzig U, Harbott J, Sperling C et al (1995) Clinical significance of surface antigen expression in children with acute myeloid leukemia: results of study AML-BFM-87. Blood 86(8):3097–3108
Borowitz MJ, Shuster JJ, Civin CI et al (1990) Prognostic significance of CD34 expression in childhood B-precursor acute lymphocytic leukemia: a Pediatric Oncology Group study. J Clin Oncol 8(8):1389–1398
Pui CH, Hancock ML, Head DR et al (1993) Clinical significance of CD34 expression in childhood acute lymphoblastic leukemia. Blood 82(3):889–894
Cascavilla N, Musto P, D’Arena G, Ladogana S, Matera R, Carotenuto M (1997) Adult and childhood acute lymphoblastic leukemia: clinico-biological differences based on CD34 antigen expression. Haematologica 82(1):31–37
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This project was funded by an extramural grant from the Indian Council of Medical Research (5/13/25/2002-NCD-III).
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Bhushan, B., Chauhan, P.S., Saluja, S. et al. Aberrant phenotypes in childhood and adult acute leukemia and its association with adverse prognostic factors and clinical outcome. Clin Exp Med 10, 33–40 (2010). https://doi.org/10.1007/s10238-009-0067-8
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DOI: https://doi.org/10.1007/s10238-009-0067-8