Ciolli S, Leoni F, Caporale R, Pascarella A, Salti F, Rossi-Ferrini P
Division of Haematology, University of Florence.
Haematologica. 1993 May-Jun;78(3):151-5.
The expression of the CD34 antigen on the blast cells of acute myeloid leukemia (AML) has been regarded as an unfavorable prognostic factor for the achievement of complete remission (CR). However, clinical reports on this issue still remain controversial. We evaluated the relationship between CD34 expression, some clinical characteristics and outcome in 80 consecutive adult AML patients.
Immunophenotyping was performed with a FACSCAN flow cytometer and CD34 was tested by HPCA-1 (My10, Becton-Dickinson). Samples were considered positive when at least 20% of cells were labeled. Promyelocytic leukemias were excluded from the study. Sixty-six patients were designed to receive intensive induction chemotherapy; 14 "low-dose" ARA-c.
Forty percent of AML were CD34 positive. In this group there was a higher incidence of less differentiated FAB subtypes (p = 0.03), but not of pre-existing myelodysplasia. No differences were found in complete remission (CR) rate, remission duration or survival. Excluding induction deaths from the analysis, the CR rate was slightly lower in CD34+ AML (55 vs 65%), without any impact on survival. We could not confirm the prognostic relevance of CD34 in adult AML, but larger studies are needed.
急性髓系白血病（AML）原始细胞上CD34抗原的表达被认为是实现完全缓解（CR）的不良预后因素。然而，关于这个问题的临床报告仍存在争议。我们评估了80例连续的成年AML患者中CD34表达、一些临床特征与预后之间的关系。
使用FACSCAN流式细胞仪进行免疫表型分析，并用HPCA-1（My10，Becton-Dickinson）检测CD34。当至少20%的细胞被标记时，样本被认为是阳性。早幼粒细胞白血病被排除在研究之外。66例患者接受强化诱导化疗；14例接受“小剂量”阿糖胞苷治疗。
40%的AML患者CD34呈阳性。在该组中，分化较差的FAB亚型发生率较高（p = 0.03），但既往存在骨髓增生异常的情况并非如此。在完全缓解（CR）率、缓解持续时间或生存率方面未发现差异。排除诱导期死亡进行分析，CD34+ AML的CR率略低（55%对65%），但对生存率没有任何影响。我们无法证实CD34在成年AML中的预后相关性，但需要更大规模的研究。
