Fruchart C, Lenormand B, Bastard C, Boulet D, Lesesve J F, Callat M P, Stamatoullas A, Monconduit M, Tilly H
Service d'Hematologie, Centre Henri Becquerel, Rouen, France.
Am J Hematol. 1996 Nov;53(3):175-80. doi: 10.1002/(SICI)1096-8652(199611)53:3<175::AID-AJH5>3.0.CO;2-W.
The hemopoietic stem cell marker CD34 has been reported to be a useful predictor of treatment outcome in acute myeloid leukemia (AML). Previous data suggested that CD34 expression may be associated with other poor prognosis factors in AML such as undifferentiated leukemia, secondary AML (SAML), and clonal abnormalities involving chromosome 5 and 7. In order to analyze the correlations between the clinicopathologic features, cytogenetic and CD34 expression in AML, we retrospectively investigated 99 patients with newly diagnosed AML: 85 with de novo disease and 14 with secondary AML (SAML). Eighty-six patients who received the same induction chemotherapy were available for clinical outcome. Defining a case as positive when > or = 20% of bone marrow cells collected at diagnosis expressed the CD34 antigen, forty-five patients were included in the CD34 positive group. Ninety patients had adequate cytogenetic analysis. Thirty-two patients (72%) with CD34 positive AML exhibited an abnormal karyotype whereas 15 patients (28%) with CD34 negative AML had abnormal metaphases (P < 0.01). Monosomy 7/7q- or monosomy 5/5q- occurred in 10 patients and 8 of them expressed the CD34 antigen (P < 0.05). All patients with t(8;21) which is considered as a favorable factor in AML had levels of CD34 >/= 20% (P < 0.05). We did not find any association between CD34 expression and attainment of complete remission, overall survival, or disease-free survival. In conclusion, the variations of CD34 expression in AML are correlated with cytogenetic abnormalities associated both with poor and favorable outcome. The evaluation of the correlations between CD34 antigen and clinical outcome in AML should take into account the results of pretreatment karyotype.
据报道，造血干细胞标志物CD34是急性髓系白血病（AML）治疗结果的有用预测指标。既往数据表明，CD34表达可能与AML的其他不良预后因素相关，如未分化白血病、继发性AML（SAML）以及涉及5号和7号染色体的克隆异常。为了分析AML的临床病理特征、细胞遗传学与CD34表达之间的相关性，我们回顾性研究了99例新诊断的AML患者：85例为原发性疾病，14例为继发性AML（SAML）。86例接受相同诱导化疗的患者可用于临床结局分析。将诊断时采集的骨髓细胞中>或 = 20%表达CD34抗原的病例定义为阳性，45例患者纳入CD34阳性组。90例患者进行了充分的细胞遗传学分析。32例（72%）CD34阳性AML患者表现为核型异常，而15例（28%）CD34阴性AML患者有异常中期分裂相（P < 0.01）。7号染色体单体/7q-或5号染色体单体/5q-发生在10例患者中，其中8例表达CD34抗原（P < 0.05）。所有被认为是AML有利因素的t(8;21)患者CD34水平>/= 20%（P < 0.05）。我们未发现CD34表达与完全缓解、总生存或无病生存之间存在任何关联。总之，AML中CD34表达的变化与预后不良和良好的细胞遗传学异常相关。评估AML中CD34抗原与临床结局之间的相关性时应考虑预处理核型的结果。
