Department of HSCT Data Management, Nagoya University School of Medicine, 1-1-20 Daiko-minami, Higashi-ku, Nagoya 461-0047, Japan.
Int J Hematol. 2010 Mar;91(2):303-9. doi: 10.1007/s12185-010-0492-1. Epub 2010 Jan 29.
Immunological phenotyping of acute leukemia have provided enormous and important information for the classification and lineage determination of leukemia. Forty-nine patients with CD7(+) CD56(+) acute myeloid leukemia (AML) were analyzed. There were 17 patients of M0, which corresponded to myeloid/NK cell precursor acute leukemia, and 32 patients of AML other than M0 (9 each for M1 and M2, one for M3, 3 for M4, 4 for M5 and 6 for M7). Age distribution was similar between these two groups, but CD7(+) CD56(+) M0 showed significant male predominance than CD7(+) CD56(+) M1-M7 (M:F = 15:2 vs. 15:17, P = 0.006). The disease localization and the hematological manifestations were different, showing fewer white blood cell counts and circulating leukemic blasts, less anemia, less thrombocytopenia and more frequent extramedullary involvement in M0 group. The prognosis was poor in both groups, and there was no statistical difference. These findings suggest that extramedullary involvement of myeloid/NK cell precursor acute leukemia is not directly derived from the presence of CD7 and CD56 antigens on leukemic cells. The poor prognosis of CD7(+) CD56(+) M1-M7 suggests that this phenotype may act as a prognostic factor for AML, but this should be confirmed in further studies.
急性白血病的免疫表型为白血病的分类和谱系确定提供了巨大而重要的信息。分析了 49 例 CD7(+) CD56(+) 急性髓系白血病 (AML) 患者。其中有 17 例为 M0,对应于髓系/NK 细胞前体急性白血病,32 例为非 M0 的 AML(M1 和 M2 各 9 例,M3 1 例,M4 3 例,M5 4 例,M7 6 例)。这两组的年龄分布相似,但 CD7(+) CD56(+) M0 组男性明显多于 CD7(+) CD56(+) M1-M7 组(M:F=15:2 比 15:17,P=0.006)。疾病定位和血液学表现不同,M0 组白细胞计数和循环白血病细胞较少,贫血、血小板减少较少,髓外累及较频繁。两组预后均较差,无统计学差异。这些发现表明,髓系/NK 细胞前体急性白血病的髓外累及并非直接来源于白血病细胞上 CD7 和 CD56 抗原的存在。CD7(+) CD56(+) M1-M7 的预后较差表明,这种表型可能是 AML 的预后因素,但这需要在进一步的研究中证实。