Naslov
Association of CD34 cell surface antigen expression with cytomorphological characteristics of acute promyelocytic leukemia blasts and clinical characteristics of patients: one center experience

Autori
Ostojić, Alen ; Pažur, Marina ; Šiftar, Zoran ; Kardum-Paro, Mirjana Mariana ; Jelić-Puškarić, Biljana ; Gredelj Šimec, Njetočka ; Radić-Krišto, Delfa ; Kardum-Skelin, Ika ; Vrhovac, Radovan ; Jakšić, Branimir

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Haematologica Vol. 96 (s2) / - , 2011, 472-472

Skup
16th Congress of the European Hematology Association

Mjesto i datum
London, Ujedinjeno Kraljevstvo, 09.06.2011. - 12.06.2011

Vrsta sudjelovanja
Ostalo

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
acute promyelocytic leukemia; cytomorphology; CD34

Sažetak
BACKGROUND: Acute promyelocytic leukemia (APL) is characterized by leukemic cells blocked at the promyelocytic stage of granulocytic differentiation (APL-blasts). According to the French-American-British (FAB) classification, two main cytological subtypes are recognized: classical hypergranular promyelocytic leukemia (M3) and the microgranular promyelocytic leukemia variant (M3v). Application of this 3-parameter classification system (nucleus, granularity and Auer rods) led to the distinction of 12 categories of APL-blasts with 3 additional categories (with basophilic granules, Chediak granules and Pelger- like maturing cells). Low or negative CD34 expression in addition to absent HLA-DR used to be the paradigm of the APL immunophenotype. However, higher CD34 expression can occur in APL and appears to be associated with leukocytosis, hypogranular morphology and poorer clinical outcome. Aims: to investigate association between cytomorphology and immunophenotypic expression of CD34 cell surface antigen of APL-blasts and their relationship with clinical and laboratory characteristics of patients with acute promyelocytic leukemia. PATIENTS AND METHODS: Sixteen consecutive patients diagnosed with APL at Department of Hematology, University Hospital Merkur, between August 1998 and December 2010, were included in this study. Patients’ clinical and laboratory features, cytomorphological characterstics of APL-blasts and their immunophenotype determined by flow cytometry were analyzed. Patients were grouped into 2 groups, CD34(-) and CD34(+), and were then compared according to clinical and laboratory characteristics. Expression in more than 20% blast cells was required to define antigen positivity. RESULTS: Mean age of patients at diagnosis was 43.9 (range: 18-78, SD14.9), 69% males and 31% females. All patients with available flow cytometry findings at diagnosis had high CD13 and CD33 expression, with HLA/DR low expression, except one who had higher HLA/DR expression (HLA/DR(-) blasts: 27.6%). There was no statistically relevant difference according to gender, age or WBC counts between the groups. Mean value of hypogranular/agranular APL-blasts in CD34(+) group was 34% (range: 9-60, SD 24.4), markedly higher than in the CD34(-) group, 11.5% (range 0-38, SD 13.7), with borderline statistical significance (P=0.055). CD34(-) patients had significantly better overall survival than CD34(+) ones (P=0.02) (fig. 1). CONCLUSION: Our results are consistent with the results of other published studies and point to the fact that higher CD34 expression and lower cytoplasmic granularity of APL-blasts are factors that seem to define a specific subgroup of patients with APL. Together with other contemporary diagnostic tools they could be of value in planning treatment of patients with acute promyelocytic leukemia.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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