Abstract
Immunological phenotyping of acute leukemia have provided enormous and important information for the classification and lineage determination of leukemia. Forty-nine patients with CD7+ CD56+ acute myeloid leukemia (AML) were analyzed. There were 17 patients of M0, which corresponded to myeloid/NK cell precursor acute leukemia, and 32 patients of AML other than M0 (9 each for M1 and M2, one for M3, 3 for M4, 4 for M5 and 6 for M7). Age distribution was similar between these two groups, but CD7+ CD56+ M0 showed significant male predominance than CD7+ CD56+ M1–M7 (M:F = 15:2 vs. 15:17, P = 0.006). The disease localization and the hematological manifestations were different, showing fewer white blood cell counts and circulating leukemic blasts, less anemia, less thrombocytopenia and more frequent extramedullary involvement in M0 group. The prognosis was poor in both groups, and there was no statistical difference. These findings suggest that extramedullary involvement of myeloid/NK cell precursor acute leukemia is not directly derived from the presence of CD7 and CD56 antigens on leukemic cells. The poor prognosis of CD7+ CD56+ M1–M7 suggests that this phenotype may act as a prognostic factor for AML, but this should be confirmed in further studies.
Similar content being viewed by others
References
Bennett JM, Catovsky D, Daniel M-T, et al. Proposals for the classification of the acute leukaemias. French–American–British (FAB) co-operative group. Br J Haematol. 1976;33:451–8.
Jaffe ES, Harris NL, Stein H, Vardiman JW. World Health Organization classification of tumours. Pathology & genetics: tumours of haematopoietic and lymphoid tissues. Lyon: IARC Press; 2001.
Bene MC, Castoldi G, Knapp W, et al. Proposals for the immunological classification of acute leukemias. Leukemia. 1995;9:1783–6.
Jennings CD, Foon KA. Recent advances in flow cytometry: application to the diagnosis of hematologic malignancy. Blood. 1997;90:2863–92.
Haferlach T, Kern W, Schnittger S, Schoch C. Modern diagnostics in acute leukemias. Crit Rev Oncol Hematol. 2005;56:223–34.
Syrjala M, Anttila VJ, Ruutu T, Jansson SE. Flow cytometric detection of residual disease in acute leukemia by assaying blasts co-expressing myeloid and lymphatic antigens. Leukemia. 1994;8:1564–70.
San Miguel JF, Martinez A, Macedo A, et al. Immunophenotyping investigation of minimal residual disease is a useful approach for predicting relapse in acute myeloid leukemia patients. Blood. 1997;90:2465–70.
Bradstock K, Matthews J, Benson E, Page F, Bishop J. Prognostic value of immunophenotyping in acute myeloid leukemia. Australian Leukaemia Study Group. Blood. 1994;84:1220–5.
Legrand O, Perrot JY, Baudard M, et al. The immunophenotype of 177 adults with acute myeloid leukemia: proposal of a prognostic score. Blood. 2000;96:870–7.
Chang H, Salma F, Yi QL, Patterson B, Brien B, Minden MD. Prognostic relevance of immunophenotyping in 379 patients with acute myeloid leukemia. Leuk Res. 2004;28:43–8.
Suzuki R, Yamamoto K, Seto M, et al. CD7+ and CD56+ myeloid/natural killer cell precursor acute leukemia: a distinct hematolymphoid disease entity. Blood. 1997;90:2417–28.
Sanchez MJ, Muench MO, Roncarolo MG, Lanier LL, Phillips JH. Identification of a common T/natural killer cell progenitor in human fetal thymus. J Exp Med. 1994;180:569–76.
Shibuya A, Nagayoshi K, Nakamura K, Nakauchi H. Lymphokine requirement for the generation of natural killer cells from CD34+ hematopoietic progenitor cells. Blood. 1995;85:3538–46.
Perez SA, Sotiropoulou PA, Gkika DG, et al. A novel myeloid-like NK cell progenitor in human umbilical cord blood. Blood. 2003;101:3444–50.
Suzuki R, Nakamura S. Malignancies of natural killer (NK) cell precursor: myeloid/NK cell precursor acute leukemia and blastic NK cell lymphoma/leukemia. Leuk Res. 1999;23:615–24.
Suzuki R, Murata M, Kami M, et al. Prognostic significance of CD7+ CD56+ phenotype and chromosome 5 abnormalities for acute myeloid leukemia M0. Int J Hematol. 2003;77:482–9.
Bennett JM, Catovsky D, Daniel M-T, et al. Proposal for the recognition of minimally differentiated acute myeloid leukemia (AML-M0). Br J Haematol. 1991;78:325–9.
Jaffe ES, Harris NL, Stein H, et al. Tumours of haematopoietic and lymphoid tissues. Lyon: IARC Press; 2001.
ISCN 2005: an International system for Human Cytogenetic Nomenclature. In: Shaffer LG, Tommerup N, editors. Basal: Karger; 2005.
Seymour JF, Pierce SA, Kantarjian HM, Keating MI, Estey EH. Investigation of karyotypic, morphologic and clinical features in patients with acute myeloid leukemia blast cells expressing the neural cell adhesion molecule (CD56). Leukemia. 1994;8:823–6.
Thomas X, Vila L, Campos L, Sabido O, Archimbaud E. Expression N-CAM (CD56) on acute leukemia cells: relationship with disease characteristics and outcome. Leuk Lymphoma. 1995;19:295–300.
Ikushima S, Yoshihara T, Matsumura T, et al. Expression of CD56/NCAM on hematopoietic malignant cells. A useful marker for acute monocytic and megakaryocytic leukemias. Int J Hematol. 1991;54:395–403.
Tallman MS, Neuberg D, Bennett JM, et al. Acute megakaryocytic leukemia: the Eastern Cooperative Oncology Group experience. Blood. 2000;96:2405–11.
Scott AA, Head DR, Kopecky KJ, et al. HLA-DR−, CD33+, CD56+ CD16− myeloid/natural killer cell acute leukemia: a previously unrecognized form of acute leukemia potentially misdiagnosed as French–American–British acute myeloid leukemia-M3. Blood. 1994;84:244–55.
Girodon F, Carli P-M, Favre B, et al. Acute myeloid leukemia with hypergranular cytoplasm: a differential diagnosis of acute promyelocytic leukemia. Leuk Res. 2000;24:979–82.
Baer MR, Stewart CC, Lawrence D, et al. Expression of the neural cell adhesion molecule CD56 is associated with short remission duration and survival in acute myeloid leukemia with t(8;21)(q22;q22). Blood. 1997;90:1643–8.
Murray CK, Estey E, Paietta E, et al. CD56 expression in acute promyelocytic leukemia: a possible indicator of poor treatment outcome? J Clin Oncol. 1999;17:293–7.
Ferrara F, Morabito F, Martino B, et al. CD56 expression is an indicator of poor clinical outcome in patients with acute promyelocytic leukemia treated with simultaneous all-trans-retinoic acid and chemotherapy. J Clin Oncol. 2000;18:1295–300.
Ito S, Ishida Y, Oyake T, et al. Clinical and biological significance of CD56 antigen expression in acute promyelocytic leukemia. Leuk Lymphoma. 2004;45:1783–9.
Raspadori D, Damiani D, Lenoci M, et al. CD56 antigenic expression in acute myeloid leukemia identifies patients with poor clinical prognosis. Leukemia. 2001;15:1161–4.
Di Bona E, Sartori R, Zambello R, Guercini N, Madeo D, Rodeghiero F. Prognostic significance of CD56 antigen expression in acute myeloid leukemia. Haematologica. 2002;87:250–6.
Raspadori D, Damiani D, Michieli M, et al. CD56 and PGP expression in acute myeloid leukemia: impact on clinical outcome. Haematologica. 2002;87:1135–40.
Suzuki R. Leukemia and lymphoma of natural killer cells. J Clin Exp Hematopathol. 2005;45:51–70.
Oshimi K. Progress in understanding and managing natural killer-cell malignancies. Br J Haematol. 2007;139:532–44.
Suzuki R, Takeuchi K, Ohshima K, Nakamura S. Extranodal NK/T-cell lymphoma: diagnosis and treatment cues. Hematol Oncol. 2008;26:66–72.
Suzuki R, Kagami Y, Takeuchi K, et al. Prognostic significance of CD56 expression for ALK-positive and ALK-negative anaplastic large cell lymphoma of T/null cell phenotype. Blood. 2000;96:2993–3000.
Asano N, Suzuki R, Kagami Y, et al. Clinicopathologic and prognostic significance of cytotoxic molecule expression in nodal peripheral T-cell lymphoma, unspecified. Am J Surg Pathol. 2005;29:1284–93.
Suzuki R, Suzumiya J, Nakamura S, et al. Hematopoietic stem cell transplantation for natural killer-cell lineage neoplasms. Bone Marrow Transplant. 2006;37:425–31.
Tassone P, Gozzini A, Goldmacher V, et al. In vitro and in vivo activity of the maytansinoid immunoconjugate huN901–N2′-deacetyl-N2′-(3-mercapto-1-oxopropyl)-maytansine against CD56+ multiple myeloma cells. Cancer Res. 2004;64:4629–36.
Ishitsuka K, Jimi S, Goldmacher VS, et al. Targeting CD56 by the maytansinoid immunoconjugate IMGN901 (huN901-DM1): a potential therapeutic modality implication against natural killer/T cell malignancy. Br J Haematol. 2008;141:129–31.
Acknowledgments
This work was supported in part by a Grant-in-Aid for the Second-Term Comprehensive 10-year Strategy for Cancer Control from the Ministry of Health, Labour, and Welfare; a Grant-in-Aid for Science on Primary Areas (Cancer Research); and a Grant-in-Aid for Encouragement of Young Scientists from the Ministry of Education, Science, and Culture, Japan.
Author information
Authors and Affiliations
Corresponding author
Appendix
Appendix
The authors thank the collaborators from the following institutions for providing the patients’ data and specimens: Akita University School of Medicine; Ohta Nishinouchi Hospital; Jikei University School of Medicine; University of Tokyo; Toranomon Hospital; Tokyo Metropolitan Komagome Hospital; Tokyo Medical University; Yaizu Municipal Hospital; Aichi Cancer Center; Nagoya City University School of Medicine; Social Insurance Kyoto Hospital; Nara Medical University; Kansai Medical University; Hyogo College of Medicine; Kochi University School of Medicine; Nagasaki University School of Medicine; Oita Prefectural Hospital.
About this article
Cite this article
Suzuki, R., Ohtake, S., Takeuchi, J. et al. The clinical characteristics of CD7+ CD56+ acute myeloid leukemias other than M0. Int J Hematol 91, 303–309 (2010). https://doi.org/10.1007/s12185-010-0492-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12185-010-0492-1