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Prognostic Significance of CD7+CD56+ Phenotype and Chromosome 5 Abnormalities for Acute Myeloid Leukemia M0

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Abstract

Myeloid/natural killer (NK) cell precursor acute leukemia is an entity of acute leukemia characterized by poor prognosis and a CD7+CD56+ myeloid antigen+ phenotype without light-microscopic myeloperoxidase reactivity. This disease shares several clinical characteristics with acute myeloid leukemia (AML) M0. To clarify the relationship between these 2 leukemias, we analyzed 105 cases of AML M0. Among them, 17 were CD7+ and CD56+, 77 were negative for either antigen, and 11 could not be determined. CD7+CD56+ AML M0 showed onset at significantly lower patient age (median 46 versus 63 years,P =.004). The disease localization and the hematological manifestations were significantly different: CD7+CD56+ AML showed more frequent extramedullary involvement, fewer circulating leukemic blasts, less anemia, and less thrombocytopenia than did AML M0. The cytogenetic aberrations were also unique, because no 5q abnormalities were found in CD7+CD56+ M0. The prognosis of CD7+CD56+ M0 was poor in patients younger than 46 years(P =.03). Multivariate analysis showed that the CD7+CD56+ phenotype was a significant prognostic factor for AML M0, as well as age, circulating blast percentage, and chromosome 5 abnormalities. These findings suggest that AML M0 consists of heterogeneous subgroups to be managed separately, and CD7+CD56+ M0 constitutes a distinct subtype of AMLM0.

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References

  1. Bennett JM, Catovsky D, Daniel M-T, et al. Proposals for the clas- sification of the acute leukaemias. French-American-British (FAB) co-operative group.Br J Haematol. 1976;33:451–458.

    Article  PubMed  CAS  Google Scholar 

  2. Foon KA,Todd RF III. Immunologic classification of leukemia and lymphoma.Blood. 1986;68:1–31.

    PubMed  CAS  Google Scholar 

  3. Neame PB, Soamboonsrup P, Browman GP, et al. Classifying acute leukemia by immunophenotyping: a combined FAB-immunologic classification of AML.Blood. 1986;68:1355–1362.

    PubMed  CAS  Google Scholar 

  4. Bene MC, Castoldi G, Knapp W, et al. Proposals for the immuno- logical classification of acute leukemias.Leukemia. 1995;9: 1783–1786.

    PubMed  CAS  Google Scholar 

  5. Bennett JM, Catovsky D, Daniel M-T, et al. Criteria for the diag- nosis of acute leukemia of megakaryocyte lineage (M7). A report of the French-American-British Cooperative Group.Ann Int Med. 1985;103:460–462.

    Article  PubMed  CAS  Google Scholar 

  6. Bennett JM, Catovsky D, Daniel M-T, et al. Proposals for the recognition of minimally differentiated acute myeloid leukemia (AML-M0).BrJ Haematol. 1991;78:325–329.

    Article  CAS  Google Scholar 

  7. Suzuki R, Yamamoto K, Seto M, et al. CD7+ and CD56+ myeloid/ natural killer cell precursor acute leukemia: a distinct hematolym- phoid disease entity.Blood. 1997;90:2417–2428.

    PubMed  CAS  Google Scholar 

  8. Nagai M, Bandoh S, Tasaka T, et al. Secondary myeloid/natural killer cell precursor acute leukemia following essential thrombocy- topenia.Hum Pathol. 1999;30:868–871.

    Article  PubMed  CAS  Google Scholar 

  9. Inaba T, Shimazaki C, Sumikuma T, et al. Clinicopathological fea- tures of myeloid/natural killer (NK) cell precursor acute leukemia.Leuk Res. 2001;25:109–113.

    Article  PubMed  CAS  Google Scholar 

  10. Handa H, Motohashi S, Isozumi K, Komatsumoto S, Nara M. CD7+ and CD56+ myeloid/natural killer cell precursor acute leukemia treated with idarubicin and cytosine arabinoside.Acta Haemato- logica. 2002;108:47–52.

    Article  Google Scholar 

  11. Ikewaki J, Otsuka E, Satou J, et al. Myeloid/natural killer cell pre- cursor acute leukaemia with minor bcr/abl mRNA transcript.Br J Haematol. 2002;118:684–685.

    Article  PubMed  Google Scholar 

  12. Tezuka K, Nakayama H, Honda K, et al. Treatment of a child with myeloid/NK cell precursor acute leukemia with L-asparaginase and unrelated cord blood transplantation.Int J Hematol. 2002;75: 201–206.

    Article  PubMed  Google Scholar 

  13. Lee EJ, Pollak A, Leavitt RD, Testa JR, Schiffer CA. Minimally dif- ferentiated acute nonlymphocytic leukemia: a distinct entity.Blood. 1987;70:1400–1406.

    PubMed  CAS  Google Scholar 

  14. Cadwell FJ, Burns CP, Dick FR, et al. Minimally differentiated acute leukemia.Leuk Res. 1993;17:199–208.

    Article  PubMed  CAS  Google Scholar 

  15. Yokose N, Ogata K, Ito T, et al. Chemotherapy for minimally dif- ferentiated acute myeloid leukemia (AML M0): a report of five cases and review of the literature.Ann Hematol. 1993;66:67–70.

    Article  PubMed  CAS  Google Scholar 

  16. Sempere A, Jarque I, Guinot M, et al. Acute myeloblastic leukemia with minimal myeloid differentiation (FAB AML-M0): a study of eleven cases.Leuk Lymphoma. 1993;12:103–108.

    Article  PubMed  CAS  Google Scholar 

  17. Stasi R, Del Poeta G, Venditti A, et al. Analysis of treatment failure in patients with minimally differentiated acute myeloid leukemia (AML-M0).Blood. 1994;83:1619–1625.

    PubMed  CAS  Google Scholar 

  18. Venditti A, Del Poeta G, Stasi R, et al. Minimally differentiated acute myeloid leukemia (AML-M0): cytochemical,immunopheno- typic and cytogenetic analysis of 19 cases.Br J Haematol. 1994;88: 784–793.

    Article  PubMed  CAS  Google Scholar 

  19. Tsunoda S, Yoshida M. Diagnosis and treatment of acute undiffer- entiated leukemia and AML M0.Rinsho Ketsueki. 1994;35:238–244.

    PubMed  CAS  Google Scholar 

  20. Cuneo A, Ferrant A, Michaux JL, et al. Cytogenetic profile of min- imally differentiated (FAB M0) acute myeloid leukemia: correla- tion with clinicobiologic findings.Blood. 1995;85:3688–3694.

    PubMed  CAS  Google Scholar 

  21. Venditti A, Del Poeta G, Buccisano F, et al. Minimally differenti- ated acute myeloid leukemia (AML-M0): comparison of 25 cases with other French-American-British subtypes.Blood. 1997;89: 621–629.

    PubMed  CAS  Google Scholar 

  22. Cohen PL, Hoyer JD, Kurtin PJ, Dewald GW, Hanson CA. Acute myeloid leukemia with minimal differentiation.Am J Clin Pathol. 1998;109:32–38.

    Article  PubMed  CAS  Google Scholar 

  23. Villamor N, Zarco M-A, Rozman M, Ribera J-M, Feliu E, Montser- rat E. Acute myeloblastic leukemia with minimal myeloid differ- entiation: phenotypical and ultrastructural characteristics.Leukemia. 1998;12:1081–1075.

    Article  Google Scholar 

  24. Huang S-Y, Tang J-L, Jou S-T, et al. Minimally differentiated acute myeloid leukemia in Taiwan: predominantly occurs in children less than 3 years and adults between 51 and 70 years.Leukemia. 1999; 13:1506–1512.

    Article  PubMed  CAS  Google Scholar 

  25. Cascavilla N, Milillo L, Díarena G, et al. Minimally differentiated acute myeloid leukemia (AML M0): clinico-biological findings of 29 cases.Leuk Lymphoma. 2000;37:105–113.

    Article  PubMed  CAS  Google Scholar 

  26. Kotylo PK, Seo I-S, Smith FO, et al. Flow cytometric immunophe- notypic characterization of pediatric and adult minimally differen- tiated acute myeloid leukemia (AML M0).Am J Clin Pathol. 2000; 113:193–200.

    Article  PubMed  CAS  Google Scholar 

  27. Kaleem Z, White G. Diagnostic criteria for minimally differenti- ated acute myeloid leukemia (AML-M0): evaluation and a proposal.Am J Clin Pathol. 2001;115:876–884.

    Article  PubMed  CAS  Google Scholar 

  28. Béné M-C, Bernier M, Casasnovas RO, et al. Acute myeloid leukemia M0: haematological, immunophenotypic and cytogenetic characteristics and their prognostic significance: an analysis in 241 patients.Br J Haematol. 2001;113:737–745.

    Article  PubMed  Google Scholar 

  29. Mitelman F, ed.ISCN 1991: Guidelines for Cancer Genetics: Supplement to an International System for Human Cytogenetic Nomenclature. Basel, Switzerland: Karger; 1992.

    Google Scholar 

  30. Sandberg AA. Cytogenetic features of special hematologic disor- ders, including some aspects of acute leukemia. In: Sandberg AA, ed.The Chromosomes in Human Cancer and Leukemia. 2nd ed. New York: Elsevier; 1990:374.

    Google Scholar 

  31. Iwata H, Kami M, Kishi Y, et al. Limitation of the diagnostic crite- ria for minimally differentiated acute myeloid leukemia (AML M0).Leukemia. 2000;14:2013–2014.

    Article  PubMed  CAS  Google Scholar 

  32. Legrand O, Perrot JY, Baudard M, et al. The immunophenotype of 177 adults with acute myeloid leukemia: proposal of a prognostic score.Blood. 2000;96:870–877.

    PubMed  CAS  Google Scholar 

  33. Hoelzer D, Thiel E, Löffler H, et al. Prognostic factors in a multi- center study for treatment of acute lymphoblastic leukemia in adults.Blood. 1988;71:123–131.

    PubMed  CAS  Google Scholar 

  34. Gaynor J, Chapman D, Little C, et al. A cause-specific hazard rate analysis of prognostic factors among 199 adults with acute lym- phoblastic leukemia: the memorial hospital experience since 1969.J Clin Oncol. 1988;6:1014–1030.

    Article  PubMed  CAS  Google Scholar 

  35. Cortes JE, Kantarjian HM. Acute lymphoblastic leukemia: a com- prehensive review with emphasis on biology and therapy.Cancer. 1995;76:2393–2417.

    Article  PubMed  CAS  Google Scholar 

  36. Czuczman MS, Dodge RK, Stewart CC, et al. Value of immunophe- notype in intensively treated adult acute lymphoblastic leukemia: Cancer and Leukemia Group B study 8364.Blood. 1999;93: 3931–3939.

    PubMed  CAS  Google Scholar 

  37. Paietta E, Neuberg D, Richards S, et al. Eastern Cooperative Oncology Group. Rare adult acute lymphocytic leukemia with CD56 expression in the ECOG experience shows unexpected phe- notypic and genotypic heterogeneity.Am J Hematol. 2001;66: 189–196.

    Article  PubMed  CAS  Google Scholar 

  38. Iizuka Y, Aiso M, Oshimi K, et al. Myeloblastoma formation in acute myeloid leukemia.Leuk Res. 1992;16:665–671.

    Article  PubMed  CAS  Google Scholar 

  39. 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;8:823–826.

    PubMed  CAS  Google Scholar 

  40. Byrd JC, Weiss RB. Recurrent granulocytic sarcoma: an unusual variation of acute myelogenous leukemia associated with 8;21 chromosomal translocation and blast expression of the neural cell adhesion molecule.Cancer. 1994;73:2107–2112.

    Article  PubMed  CAS  Google Scholar 

  41. 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.

    Article  PubMed  CAS  Google Scholar 

  42. 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;90:1643–1648.

    PubMed  CAS  Google Scholar 

  43. 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;17:293–297.

    Article  PubMed  CAS  Google Scholar 

  44. Ferrara F, Morabito F, Martino B, et al. CD56 expression is an indi- cator of poor clinical outcome in patients with acute promyelocytic leukemia treated with simultaneous all-trans-retinoic acid and chemotherapy.J Clin Oncol. 2000;18:1295–1300.

    Article  PubMed  CAS  Google Scholar 

  45. Abruzzo LV, Jaffe ES, Cotelingam JD, Whang-Peng J, Del Duca V Jr, Medeiros LJ. T-cell lymphoblastic lymphoma with eosinophilia associated with subsequent myeloid malignancy.Am J Surg Pathol. 1992;16:236–245.

    Article  PubMed  CAS  Google Scholar 

  46. Inhorn RC, Aster JC, Roach SA, et al. A syndrome of lymphoblas- tic lymphoma, eosinophilia, and myeloid hyperplasia/malignancy associated with t(8;13)(p11;q11): description of a distinctive clini- copathologic entity.Blood. 1995;85:1881–1887.

    PubMed  CAS  Google Scholar 

  47. 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.

    PubMed  CAS  Google Scholar 

  48. Fernandez LA, Pope B, Lee C, Zayed E. Aggressive natural killer cell leukemia in an adult and establishment of an NK cell line.Blood. 1986;67:925–930.

    PubMed  CAS  Google Scholar 

  49. Yamaguchi M, Kita K, Miwa H, et al. Frequent expression of P-gly- coprotein/ MDR1 by nasal T-cell lymphoma cells.Cancer. 1995;76: 2351–2356.

    Article  PubMed  CAS  Google Scholar 

  50. Kwong YL, Chan ACL, Liang R, Chiang AKS, Chim CS, Chan TK. CD56+ NK lymphomas: clinicopathological features and prognosis.BrJ Haematol. 1997;97:821–829.

    Article  CAS  Google Scholar 

  51. Cheung MMC, Chan JKC, Lau WH, et al. Primary non-Hodgkin’s lymphoma of the nose and nasopharynx: clinical features, tumor immunophenotype, and treatment outcome in 113 patients.J Clin Oncol. 1998;16:70–77.

    Article  PubMed  CAS  Google Scholar 

  52. 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;23:615–624.

    Article  PubMed  CAS  Google Scholar 

  53. Mraz-Gernhard S, Natkunam Y, Hoppe RT, LeBoit P, Kohler S, Kim YH. Natural killer/natural killer-like T-cell lymphoma, CD56+, presenting in the skin: an increasingly recognized entity with an aggressive course.J Clin Oncol. 2001;19:2179–2188.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Molecular Medicine, Nagoya, Japan

    Ritsuro Suzuki & Masao Seto

  2. Department of Hematology and Chemotherapy, Nagoya, Japan

    Ritsuro Suzuki & Yasuo Morishima

  3. Division of Epidemiology and Prevention, Nagoya, Japan

    Nobuyuki Hamajima

  4. Department of Pathology and Molecular Diagnosis, Nagoya, Japan

    Shigeo Nakamura

  5. Aichi Cancer Center, Nagoya, Japan

    Ryuzo Ohno

  6. Department of Internal Medicine, Nagoya University School of Medicine, Nagoya, Japan

    Makoto Murata

  7. Department of Hematology, Toranomon Hospital, Tokyo, Japan

    Masahiro Kami

  8. Third Department of Internal Medicine, Kanazawa University School of Medicine, Kanazawa, Japan

    Shigeki Ohtake

  9. Second Department of Internal Medicine, Kumamoto University School of Medicine, Kumamoto, Japan

    Norio Asou

  10. Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Yoshihisa Kodera

  11. Department of Hematology, Nagasaki University School of Medicine, Nagasaki, Japan

    Masao Tomonaga

  12. Department of Internal Medicine, Kanazawa Medical University, Ishikawa, Japan

    Yasufumi Masaki

  13. First Department of Internal Medicine, Saitama Medical School, Saitama, Japan

    Shuya Kusumoto

  14. First Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan

    Jin Takeuchi

  15. Center for Hematopoietic Disorders, Ohta Nishinouchi Hospital, Koriyama, Japan

    Shin Matsuda

  16. Department of Hematology and Oncology, Faculty of Medicine, University of Tokyo, Tokyo, Japan

    Hisamaru Hirai

  17. Department of Internal Medicine, Kochi Central Hospital, Kochi, Japan

    Seiichi Yorimitsu

  18. National Nagoya Hospital, Nagoya, Japan

    Masanori Shimoyama

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  1. Ritsuro Suzuki
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  2. Makoto Murata
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  3. Masahiro Kami
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  18. Yasuo Morishima
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  19. Shigeo Nakamura
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Correspondence to Shigeo Nakamura.

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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 77, 482–489 (2003). https://doi.org/10.1007/BF02986617

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  • DOI: https://doi.org/10.1007/BF02986617

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