Perea G, Domingo A, Villamor N, Palacios C, Juncà J, Torres P, Llorente A, Fernández C, Tormo M, Queipo de Llano M P, Bargay J, Gallart M, Florensa L, Vivancos P, Martí J M, Font Ll, Berlanga J, Esteve J, Bueno J, Ribera J M, Brunet S, Sierra J, Nomdedéu J F
Laboratori d'Hematologia, Hospital de la Santa Creu i Sant Pau, Avda Sant Antoni M. Claret, 167, 08025 Barcelona, Spain.
Leuk Res. 2005 Oct;29(10):1109-16. doi: 10.1016/j.leukres.2005.02.015.
A consecutive series of acute myeloid leukemias (AML) patients was analyzed in conditions which reduce the inter-assay variations (the same flow cytometer, the same observers and the same panel of monoclonal antibodies) in order to investigate the prognostic information provided by flow cytometry.
Two hundred and sixty-six bone marrow (BM) samples from 326 patients enrolled in the LMA-99 protocol from the CETLAM group were studied by multiparametric flow cytometry. Immunophenotyping studies were performed on erythrocyte-lysed BM samples. Antigen expression of leukemic cells was analyzed using triple stainings with fluorochrome-conjugated combinations of monoclonal antibodies.
CD2 was positive in 21 cases (8%); an associated inv(16) was detected in eight CD2+ cases (38%). Two-year overall survival (OS) rate for CD2+/inv(16)+ patients was 75%, whereas it was 0% for CD2+/inv(16)- patients and 47% for CD2- patients (p=0.0001). CD36 was expressed in 37% of patients (n=98). Two-year leukemia-free survival (LFS) rate was 34% for CD36+ patients and 55% for CD36- patients (p=0.001). In the multivariate analysis, CD2+ (RR=8.4; p=0.0001) and adverse karyotype (RR=10.2; p=0.0001) were associated with a lower CR rate, CD36+ (RR=1.5; p=0.03), CD2+ (RR=2; p=0.04) and adverse karyotype (RR=4; p=0.0001) were associated with a lower OS and CD36+ (RR=2; p=0.002) and adverse karyotype (RR=3.5; p=0.005) predicted a lower LFS.
CD2+ patients had a very poor OS when CD2/inv(16)+ cases were excluded. CD36 and CD2 expression at diagnosis can provide prognostically important information in adult de novo AML.
对一系列急性髓系白血病（AML）患者进行分析，分析条件为减少检测间差异（使用同一流式细胞仪、相同的观察者以及相同的单克隆抗体组合），以研究流式细胞术所提供的预后信息。
对来自CETLAM组LMA - 99方案的326例患者的266份骨髓（BM）样本进行多参数流式细胞术研究。对红细胞裂解后的BM样本进行免疫表型分析。使用荧光素偶联的单克隆抗体组合进行三重染色分析白血病细胞的抗原表达。
21例（8%）患者CD2呈阳性；8例CD2阳性病例（38%）检测到相关的inv(16)。CD2 + /inv(16) + 患者的两年总生存率（OS）为75%，而CD2 + /inv(16) - 患者为0%，CD2 - 患者为47%（p = 0.0001）。37%的患者（n = 98）表达CD36。CD36 + 患者的两年无白血病生存率（LFS）为34%，CD36 - 患者为55%（p = 0.001）。在多变量分析中，CD2 + （相对风险[RR]=8.4；p = 0.0001）和不良核型（RR = 10.2；p = 0.0001）与较低的完全缓解（CR）率相关，CD36 + （RR = 1.5；p = 0.03）、CD2 + （RR = 2；p = 0.04）和不良核型（RR = 4；p = 0.0001）与较低的OS相关，CD36 + （RR = 2；p = 0.002）和不良核型（RR = 3.5；p = 0.005）预示较低的LFS。
排除CD2/inv(16) + 病例后，CD2 + 患者的OS非常差。诊断时CD36和CD2的表达可为成人初发AML提供重要的预后信息。
