Miwa H, Nakase K, Kita K
Second Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan.
Leuk Lymphoma. 1996 Apr;21(3-4):239-44.
Eighty six of 430 acute myeloblastic leukemia (AML) patients (20.0%) and forty of 173 acute lymphoblastic leukemia (ALL) patients (23.1%) had CD7 on their leukemia cells. CD7(+) AML occurred at a younger age than CD7(-) AML, and is more frequent in males. Hepatomegaly and central nervous system involvement were also more frequent in CD7(+) AML than in CD7(-) AML. The age of onset of CD7(+) ALL is also younger than that of CD7(-) ALL. Phenotypically, CD(+) AML expressed CD34, HLA-DR, and TdT more frequently than CD7(-) AML while CD7(+) ALL expressed CD13/33 more often than CD7(-) ALL cells responded most significantly to interleukin 3 (IL-3), whereas most CD7(-) AML cells responded more significantly to granulocyte macrophage-colony stimulating factor (GM-CSF) and/or granulocyte (G)-CSF than to IL-3. CD7(+)sCD3(-)CD4(-)CD8(-) ALL expressed G-CSF receptor and c-kit mRNA more frequently, which is not usual in other types of ALL. P-glycoprotein (P-gp)/multi-drug resistance gene (MDR1), thought to be expressed in hematopoietic stem cells, is expressed in CD7(+) AML and CD7(+)sCD3(-) CD4(-)CD8(-) ALL significantly more often than in CD7(-) acute leukemias and the CR rate and overall survival of CD7(+)AML was worse than CD7(-) AML. These data, collectively, suggest the close association of CD7(+) AML and CD7(+)sCD3(-)CD4(-)CD8(-) ALL, not only the common expression of CD7 itself but also because their phenotypical immaturity, cytokine receptor expression, P-gp/MDR1 expression and clinical manifestations including the frequent occurrence in males and the poor prognosis. We propose that CD7(+) acute leukemia is an hematopoietic stem cell leukemia which may be separate entity.
430例急性髓细胞白血病（AML）患者中有86例（20.0%），173例急性淋巴细胞白血病（ALL）患者中有40例（23.1%）白血病细胞表达CD7。CD7(+) AML发病年龄比CD7(-) AML小，且在男性中更常见。肝肿大和中枢神经系统受累在CD7(+) AML中也比CD7(-) AML更常见。CD7(+) ALL的发病年龄也比CD7(-) ALL小。表型上，CD(+) AML比CD7(-) AML更频繁地表达CD34、HLA-DR和TdT，而CD7(+) ALL比CD7(-) ALL更频繁地表达CD13/33。大多数CD7(+)细胞对白细胞介素3（IL-3）反应最显著，而大多数CD7(-) AML细胞对粒细胞巨噬细胞集落刺激因子（GM-CSF）和/或粒细胞（G）-CSF的反应比对IL-3更显著。CD7(+)sCD3(-)CD4(-)CD8(-) ALL更频繁地表达G-CSF受体和c-kit mRNA，这在其他类型的ALL中并不常见。被认为在造血干细胞中表达的P-糖蛋白（P-gp）/多药耐药基因（MDR1），在CD7(+) AML和CD7(+)sCD3(-) CD4(-)CD8(-) ALL中的表达明显比在CD7(-)急性白血病中更频繁，且CD7(+)AML的完全缓解率和总生存率比CD7(-) AML更差。这些数据共同表明CD7(+) AML和CD7(+)sCD3(-)CD4(-)CD8(-) ALL密切相关，不仅因为CD7本身的共同表达，还因为它们的表型不成熟、细胞因子受体表达、P-gp/MDR1表达以及包括男性中频繁发生和预后不良在内的临床表现。我们提出CD7(+)急性白血病是一种造血干细胞白血病，可能是一个独立的实体。
