International Journal of Hematology

, Volume 91, Issue 2, pp 303–309

The clinical characteristics of CD7+ CD56+ acute myeloid leukemias other than M0

  • Ritsuro Suzuki
  • Shigeki Ohtake
  • Jin Takeuchi
  • Masami Nagai
  • Yoshihisa Kodera
  • Motohiro Hamaguchi
  • Shuichi Miyawaki
  • Takahiro Karasuno
  • Shigetaka Shimodaira
  • Ryuzo Ohno
  • Shigeo Nakamura
  • Tomoki Naoe
Original Article


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.


Acute myeloid leukemia Immunophenotyping CD7 CD56 


  1. 1.
    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.CrossRefPubMedGoogle Scholar
  2. 2.
    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.Google Scholar
  3. 3.
    Bene MC, Castoldi G, Knapp W, et al. Proposals for the immunological classification of acute leukemias. Leukemia. 1995;9:1783–6.PubMedGoogle Scholar
  4. 4.
    Jennings CD, Foon KA. Recent advances in flow cytometry: application to the diagnosis of hematologic malignancy. Blood. 1997;90:2863–92.PubMedGoogle Scholar
  5. 5.
    Haferlach T, Kern W, Schnittger S, Schoch C. Modern diagnostics in acute leukemias. Crit Rev Oncol Hematol. 2005;56:223–34.CrossRefPubMedGoogle Scholar
  6. 6.
    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.PubMedGoogle Scholar
  7. 7.
    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.PubMedGoogle Scholar
  8. 8.
    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.PubMedGoogle Scholar
  9. 9.
    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.PubMedGoogle Scholar
  10. 10.
    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.CrossRefPubMedGoogle Scholar
  11. 11.
    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.PubMedGoogle Scholar
  12. 12.
    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.CrossRefPubMedGoogle Scholar
  13. 13.
    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.PubMedGoogle Scholar
  14. 14.
    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.CrossRefPubMedGoogle Scholar
  15. 15.
    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.CrossRefPubMedGoogle Scholar
  16. 16.
    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.CrossRefPubMedGoogle Scholar
  17. 17.
    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.CrossRefPubMedGoogle Scholar
  18. 18.
    Jaffe ES, Harris NL, Stein H, et al. Tumours of haematopoietic and lymphoid tissues. Lyon: IARC Press; 2001.Google Scholar
  19. 19.
    ISCN 2005: an International system for Human Cytogenetic Nomenclature. In: Shaffer LG, Tommerup N, editors. Basal: Karger; 2005.Google Scholar
  20. 20.
    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.PubMedGoogle Scholar
  21. 21.
    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.CrossRefPubMedGoogle Scholar
  22. 22.
    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.PubMedGoogle Scholar
  23. 23.
    Tallman MS, Neuberg D, Bennett JM, et al. Acute megakaryocytic leukemia: the Eastern Cooperative Oncology Group experience. Blood. 2000;96:2405–11.PubMedGoogle Scholar
  24. 24.
    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.PubMedGoogle Scholar
  25. 25.
    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.CrossRefPubMedGoogle Scholar
  26. 26.
    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.PubMedGoogle Scholar
  27. 27.
    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.PubMedGoogle Scholar
  28. 28.
    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.PubMedGoogle Scholar
  29. 29.
    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.CrossRefPubMedGoogle Scholar
  30. 30.
    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.CrossRefPubMedGoogle Scholar
  31. 31.
    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.PubMedGoogle Scholar
  32. 32.
    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.PubMedGoogle Scholar
  33. 33.
    Suzuki R. Leukemia and lymphoma of natural killer cells. J Clin Exp Hematopathol. 2005;45:51–70.CrossRefGoogle Scholar
  34. 34.
    Oshimi K. Progress in understanding and managing natural killer-cell malignancies. Br J Haematol. 2007;139:532–44.CrossRefPubMedGoogle Scholar
  35. 35.
    Suzuki R, Takeuchi K, Ohshima K, Nakamura S. Extranodal NK/T-cell lymphoma: diagnosis and treatment cues. Hematol Oncol. 2008;26:66–72.CrossRefPubMedGoogle Scholar
  36. 36.
    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.PubMedGoogle Scholar
  37. 37.
    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.CrossRefPubMedGoogle Scholar
  38. 38.
    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.CrossRefPubMedGoogle Scholar
  39. 39.
    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.CrossRefPubMedGoogle Scholar
  40. 40.
    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.CrossRefPubMedGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2010

Authors and Affiliations

  • Ritsuro Suzuki
    • 1
  • Shigeki Ohtake
    • 2
  • Jin Takeuchi
    • 3
  • Masami Nagai
    • 4
  • Yoshihisa Kodera
    • 5
  • Motohiro Hamaguchi
    • 6
  • Shuichi Miyawaki
    • 7
  • Takahiro Karasuno
    • 8
  • Shigetaka Shimodaira
    • 9
  • Ryuzo Ohno
    • 10
  • Shigeo Nakamura
    • 11
  • Tomoki Naoe
    • 12
  1. 1.Department of HSCT Data ManagementNagoya University School of MedicineNagoyaJapan
  2. 2.Third Department of Internal MedicineKanazawa University School of MedicineKanazawaJapan
  3. 3.Department of Internal MedicineNihon University School of MedicineTokyoJapan
  4. 4.First Department of Internal MedicineKagawa Medical UniversityTakamatsuJapan
  5. 5.Department of Internal MedicineJapanese Red Cross Nagoya First HospitalNagoyaJapan
  6. 6.Department of HematologyNational Hospital Organization, Nagoya Medical CenterNagoyaJapan
  7. 7.Department of Internal MedicineSaiseikai Maebashi HospitalMaebashiJapan
  8. 8.Department of Internal MedicineOsaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
  9. 9.Department of Internal MedicineJapanese Red Cross Nagano HospitalNaganoJapan
  10. 10.Aichi Cancer CenterNagoyaJapan
  11. 11.Department of PathologyNagoya University School of MedicineNagoyaJapan
  12. 12.Department of Hematology and OncologyNagoya University School of MedicineNagoyaJapan

Personalised recommendations