Complex Measurements May Be Required to Establish the Prognostic Impact of Immunophenotypic Markers in AML. Issue 3 (1st September 2015)

• Record Type: Journal Article
• Authors: García-Dabrio, Maria Concepcion; Hoyos, Montserrat; Brunet, Salut; Tormo, Mar; Ribera, Josep-Maria; Esteve, Jordi; Gallardo, David; Duarte, Rafael F.; de Llano, Maria Paz Queipo; Bargay, Joan; Martí-Tutusaus, Josep M.; Heras, Inmaculada; Garcia, Antoni; Salamero, Olga; Aventin, Anna; Lecrevisse, Quentin; Orfao, Alberto; Sierra, Jorge; Nomdedéu, Josep F.
• Is Part Of: American journal of clinical pathology. Volume 144:Issue 3(2015)
• Page Start: 484
• Page End: 492
• Publication Date: 2015-09-01
• Subjects: AML -- Multiparameter flow cytometry -- Mean fluorescence intensity -- Blast cell heterogeneity -- Prognosis; Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1309/AJCPRL6XSVFMLH9V
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Objectives: The prognostic impact of immunophenotypic markers in acute myeloid leukemia (AML) is controversial. Methods: We retrospectively analyzed the value of CD34, CD117, CD7, and CD123 expression in a consecutive series of 592 adult patients with de novo AML. Results: CD34+ measured as a percentage (≥2.88%) and CD34 mean fluorescence intensity (MFI) (≥146.79, arbitrary units [AU]) expression had a prognostic impact in terms of overall survival (OS; P = .005, P = .003), leukemia-free survival (LFS; P = .011, P < .001), and cumulative incidence of relapse (CIR; P = .014, P =. 001). The percentage of CD117+ cells (61.29%) was associated with shorter LFS (P =. 043), and CD117 MFI (≥284.01 AU) was associated with a shorter OS (P =. 033) and LFS (P =. 028). In the multivariate analysis, high CD34 MFI retained the independent value as predictor of LFS and CIR (P =. 012; hazard ratio [HR], 1.59; 95% confidence interval [CI], 1.11–2.28 and P =. 045; HR, 1.58; 95% CI, 1.01–2.46). Conclusions: CD34 positivity threshold with prognostic relevance is low (3% positive cells). Immunophenotypic findings in AML probably could only be fully exploited after a complex analysis that takes into account unconventional thresholds and the MFI.