El-Meligui Yomna M, Abd Elrhman Heba E, Salahuddin Ahmad, Hamouda Manal Ali, Kassem Amira B
Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Pharmgenomics Pers Med. 2021 Mar 30;14:381-393. doi: 10.2147/PGPM.S268986. eCollection 2021.
Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults. HLA-DR and CD117 (c-Kit) are important diagnostic markers of AML. Our objective is to determine the prognostic significance of HLA-DR and CD117 expressions in newly diagnosed AML patients and determine the correlation between HLA-DR and CD117 expressions and other prognostic markers such as cytogenetic abnormalities, FLT3-ITD, response to treatment, and patient's survival.
This study included 100 newly diagnosed AML patients. All patients were subjected to clinical, morphological, cytochemical, cytogenetic analysis, molecular genetic analysis to detect FLT3-ITD, and Flowcytometric detection of HLA-DR, CD117, and CD 34.
The results showed that HLA-DR expression was found in 75 patients (77.3%), while CD117 expression was found in 63 patients (64.9%). Patients with HLA-DR expression showed significantly higher mean Hb concentration, significantly higher platelet count, associated with AML-FAB subtypes (M0, M1, and M2), CD34 expression, and favorable cytogenetic group. M3 subtype was significantly associated with HLA-DR-ve. While patients with CD117 expression showed significantly lower platelets count. Double positive patients (HLA-DR+ve/CD117+ve) showed significant association with the intermediate cytogenetic group, while double-negative patients (HLA-DR-ve/CD117-ve) were associated with the favorable and intermediate cytogenetic group and either positive (HLA-DR+ve /CD117-ve or HLA-DR-ve/CD117+ve) associated with poor cytogenetic groups. FLT3-ITD expression had significantly worse overall survival.
The current study suggested that the expression of CD117 and HLA-DR may be a prognostic marker in AML, as they are associated with M0, M1, and M2 FAB subtypes; moreover, patients with combined HLA-DR and CD117 positive expression are associated with CD34 expression and intermediate cytogenetic group.
急性髓系白血病（AML）是成人中最常见的急性白血病类型。HLA - DR和CD117（c - Kit）是AML的重要诊断标志物。我们的目的是确定HLA - DR和CD117表达在新诊断的AML患者中的预后意义，并确定HLA - DR和CD117表达与其他预后标志物（如细胞遗传学异常、FLT3 - ITD、治疗反应和患者生存率）之间的相关性。
本研究纳入了100例新诊断的AML患者。所有患者均接受了临床、形态学、细胞化学、细胞遗传学分析、检测FLT3 - ITD的分子遗传学分析以及HLA - DR、CD117和CD 34的流式细胞术检测。
结果显示，75例患者（77.3%）检测到HLA - DR表达，63例患者（64.9%）检测到CD117表达。HLA - DR表达的患者平均血红蛋白浓度显著更高，血小板计数显著更高，与AML - FAB亚型（M0、M1和M2）、CD34表达以及良好的细胞遗传学分组相关。M3亚型与HLA - DR阴性显著相关。而CD117表达的患者血小板计数显著更低。双阳性患者（HLA - DR阳性/CD117阳性）与中间细胞遗传学分组显著相关，而双阴性患者（HLA - DR阴性/CD117阴性）与良好和中间细胞遗传学分组相关，单阳性患者（HLA - DR阳性/CD117阴性或HLA - DR阴性/CD117阳性）与不良细胞遗传学分组相关。FLT3 - ITD表达的总生存率显著更差。
当前研究表明，CD117和HLA - DR的表达可能是AML的预后标志物，因为它们与M0、M1和M2 FAB亚型相关；此外，HLA - DR和CD117联合阳性表达的患者与CD34表达和中间细胞遗传学分组相关。
