Nakamura A, Tsurusawa M, Kato A, Taga T, Hatae Y, Miyake M, Mimaya J, Onodera N, Watanabe A, Watanabe T, Kanegane H, Matsushita T, Iwai A, Hyakuna N, Gushi K, Kawakami T, Sekine I, Izichi O, Asami K, Kikuta A, Tanaka A, Fujimoto T
Department of Pediatrics, Aichi Medical University, Aichi, 480-1195 Japan.
Leuk Lymphoma. 2001 Jul;42(3):393-8. doi: 10.3109/10428190109064596.
To evaluate the clinical implications of CD45 expression in acute childhood lymphoblastic leukemia (ALL), we measured the CD45 expression of blast cells from 133 untreated patients with childhood B-precursor ALL (n = 118) or T-ALL (n = 15). CD45 expression (> or = 20%) was detected in all 15 cases (100%) of T-ALL, and 101 cases (86%) of B-precursor ALL. In 122 cases, the fluorescence intensity of the CD45 expression was measured as a relative value; the ratio of average linear values (RALV) of CD45 on the blasts to that on CD3-positive T-lymphocytes from the same specimen. The expression was more intense in the T-ALL cases than in the B-precursor ALL cases (RALV, mean +/- SE: T-ALL 0.230 +/- 0.04 vs. pro-B ALL 0.150 +/- 0.012/pre-B ALL 0.153 +/- 0.019, p < 0.05). However, the intensity of the CD10, CD19, CD20 and CD34 antigen immunoreactivity did not correlate with the CD45 expression. Patients with hyperdiploidy (chromosome number > 50) showed significantly lower levels of CD45 expression than patients with t(1;19) or normal karyotypes (RALV, mean +/- SE: 0.081 +/- 0.022 vs. 0.133 +/- 0.03/0.143 +/- 0.019, p < 0.05). Other clinical features such as age, gender and WBC count did not correlate with CD45 expression. The prognostic implications of CD45 expression were studied in non-high-risk (low-risk + intermediate-risk) (n = 60) and high-risk patients (n = 52) with B-precursor ALL who had been treated with the risk-directed protocol of ALL-941 trial. Although CD45 expression did not correlate with the event-free survival (EFS) of the non-high-risk patients, there was a significant correlation between the expression levels and the EFS of the high-risk patients: the 3-year EFS rate of the CD45low group (n = 26, RALV = 0.017-0.132) was 88 +/- 7% versus the CD45high group (n = 26, RALV = 0.133-0.450) at 34 +/- 24% (p < 0.05). These results show that the levels of expression of the CD45 antigen on leukemic lymphoblasts are significantly correlated with the clinical features and prognosis of childhood ALL.
为评估CD45表达在儿童急性淋巴细胞白血病（ALL）中的临床意义，我们检测了133例未经治疗的儿童B前体ALL患者（n = 118）或T-ALL患者（n = 15）原始细胞的CD45表达。在所有15例（100%）T-ALL及101例（86%）B前体ALL中均检测到CD45表达（≥20%）。在122例患者中，测量了CD45表达的荧光强度作为相对值；即同一标本中原始细胞上CD45的平均线性值（RALV）与CD3阳性T淋巴细胞上CD45的平均线性值之比。T-ALL病例中的表达比B前体ALL病例更强烈（RALV，均值±标准误：T-ALL为0.230±0.04，pro-B ALL为0.150±0.012/pre-B ALL为0.153±0.019，p<0.05）。然而，CD10、CD19、CD20和CD34抗原免疫反应强度与CD45表达无关。超二倍体（染色体数>50）患者的CD45表达水平显著低于t(1;19)或核型正常的患者（RALV，均值±标准误：0.081±0.022 vs. 0.133±0.03/0.143±0.019，p<0.05）。其他临床特征如年龄、性别和白细胞计数与CD45表达无关。在接受ALL-941试验风险导向方案治疗的非高危（低危+中危）（n = 60）和高危（n = 52）B前体ALL患者中研究了CD45表达的预后意义。虽然CD45表达与非高危患者的无事件生存期（EFS）无关，但表达水平与高危患者的EFS有显著相关性：CD45低表达组（n = 26，RALV = 0.017 - 0.132）的3年EFS率为88±7%，而CD45高表达组（n = 26，RALV = 0.133 - 0.450）为34±24%（p<0.05）。这些结果表明，白血病原始淋巴细胞上CD45抗原的表达水平与儿童ALL的临床特征和预后显著相关。
