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Higher Level of Peripheral Blood CD34 Positive Cells Presented with Unfavorable Prognosis in Intermediate-Low Risk Acute Promyelocytic Leukemia

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Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

Our previous work has demonstrated that some acute promyelocytic leukemia (APL) patients had significantly elevated circulating CD34+ cell count (≥ 10 × 106/L), and these patients with higher CD34+ cell level usually presented with high-risk disease (WBC > 10,000/μL). The aim of this study was to investigate whether circulating CD34+ cell count is a prognostic marker in intermediate-low risk APL patients. In this study, 76 intermediate-low risk APL patients and 56 age-adjusted healthy volunteers were evaluated. Enumeration of CD34+ cells was investigated before the treatment. A cut-off value of 10 × 106/L CD34+ cells could just distinguish APL patients with adverse prognostic factors from others and may have the power to predict shorter progression-free survival (PFS) and poor prognosis. Higher count of CD34+ cells was usually associated with nonclassical chromosomal translocation, PML/RARα gene complex fusion, APL history, chemotherapy-related APL, disease progression, second tumor, extramedullary infiltration, FLT3-ITD positive mutation, atypical morphology, BM promyelocyte CD56/CD34 positive expression, myelofibrosis, PCR-positive PML/RARa gene fusion but FISH-negative, marrow necrosis and shorter PFS. Our results suggest that the level of CD34+ cells can be further the stratification of disease risk, a higher CD34+ cell count may be indicative of inferior survival and serve as an adverse biomarker for intermediate-low risk APL.

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Abbreviations

APL:

Acute promyelocytic leukemia

PFS:

Progression-free survival

OS:

Overall survival

ATRA:

All-transretinoic acid

CR:

Complete remission

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Authors and Affiliations

  1. Department of Hematology, Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, 210093, People’s Republic of China

    Cuiling Zhang, Haibo Dong, Yipeng Lin, Peipei Xu, Rongfu Zhou & Hui Zeng

  2. Department of Hematology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, People’s Republic of China

    Hui Zeng

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  1. Cuiling Zhang
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  2. Haibo Dong
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  3. Yipeng Lin
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  4. Peipei Xu
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  5. Rongfu Zhou
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  6. Hui Zeng
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Correspondence to Hui Zeng.

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The study protocol received institutional review board approval and that the participants provided informed consent. All patient’s personal data have been secured.

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Cuiling Zhang and Haibo Dong are co-first author.

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Zhang, C., Dong, H., Lin, Y. et al. Higher Level of Peripheral Blood CD34 Positive Cells Presented with Unfavorable Prognosis in Intermediate-Low Risk Acute Promyelocytic Leukemia. Indian J Hematol Blood Transfus 36, 309–315 (2020). https://doi.org/10.1007/s12288-019-01232-4

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  • DOI: https://doi.org/10.1007/s12288-019-01232-4

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