Abstract
CD34 positivity has been considered as an adverse prognostic factor in acute myeloid leukemia (AML). Although nucleophosmin 1-mutated (NPM1m) AML is usually CD34 negative, this marker may be expressed at diagnosis or acquired at relapse in a variable number of cases. Our objective was to ascertain if CD34 expression has any influence on the general outcome of this form of acute leukemia. Analysis of clinical outcome (complete remissions, relapses, disease-free survival, and overall survival) was performed depending on the degree of expression of CD34 determined by flow cytometry, in 67 adult patients with NPM1m AML. CD34 expression did not have any influence on the variables analyzed whatever the percentage of blasts expressing this marker. In contrast to other forms of AML, CD34 expression is not an unfavorable prognostic factor in NPM1m AML, neither at diagnosis nor at relapse.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri S, Stein H, et al. (Editors). International Agency for Research on Cancer. World Health Organization classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon: International Agency for Research on Cancer; 2008
Nomdedeu J, Bussaglia E, Villamor N, Martínez C, Esteve J, Tormo M et al (2011) Immunophenotype of acute myeloid leukemia with NPM mutations: prognostic impact of leukemic compartment size. Leuk Res 35:163–168
Dang H, Chen Y, Kamel-Reid S, Brandwein J, Chang H (2013) CD34 expression predicts an adverse outcome in patients with NPM1-positive acute myeloid leukemia. Human Pathology 44:2038–2046
Liu YR, Zhu HH, Ruan GR, Ya ZK, Shi HX, Lay YY et al (2013) NPM1-mutated acute myeloid leukemia of monocytic or myeloid origin exhibit distinct phenotypes. Leuk Res 37:737–741
Krönke J, Bullinger L, Teleanu V, Tschürtz F, Gaidzik VI, Kühn MWM et al (2013) Clonal evolution in relapsed NPM1-mutated acute myeloid leukemia. Blood 122:100–108
Ossenkoppele GJ, van de Loosdrecht AA, Schuurhuis GJ (2011) Review of the relevance of aberrant antigen expression by flow cytometry in myeloid neoplasms. Br J Haematol 153:421–436
Casasnovas RO, Slimane FK, Garand R, Faure GC, Campos L, Deneys V et al (2003) Immunological classification of acute myeloblastic leukemias: relevance to patient outcome. Leukemia 17:515–527
Webber BA, Cushing MM, Li S (2008) Prognostic significance of flow cytometric immunophenotyping in acute myeloid leukemia. Int J Clin Exp Pathol 1:124–133
García-Dabrio C, Hoyos M, Brunet S, Tormo M, Ribera JM, Esteve J et al (2015) Complex measurements may be required to establish the prognostic impact of immunophenotypic markers in AML. Am J Clin Pathol 144:484–92
Iriyama N, Asou N, Miyazaki Y, Tamaguchi S, Sato S, Sakura T et al (2014) Normal karyotype acute myeloid leukemia with the CD7+ CD15+ CD34+ HLA-DR+ immunophenotype is a clinically distinct entity with a favorable outcome. Ann Hematol 93:957–63
Zhu HH, Liu YR, Jiang H, Lu J, Qin YZ, Jiang Q et al (2013) CD34 expression on bone marrow blasts is a novel predictor of poor prognosis independent of FLT3-ITD in acute myeloid leukemia with the NPM1-mutation. Leuk Res 37:624–630
Döhner K, Schlenk RF, Habdank M, Scholl C, Rücker FG, Corbacioglu A et al (2005) Mutant nucleophosmin (NPM1) predicts favorable prognosis in younger adults with acute myeloid leukemia and normal cytogenetics: interaction with other gene mutations. Blood 106:3740–3746
Jiang A, Jiang H, Brandwein J, Kamel-Reid S, Chang H (2011) Prognostic factors in normal karyotype acute myeloid leukemia in the absence of the FLT3-ITD mutation. Leuk Res 35:492–498
Chen CH, Chou WC, Tsay W, Tang JL, Yao M, Huang SY et al (2013) Hierarchical cluster analysis of immunophenotype classify AML patients with NPM1 gene mutation into two groups with distinct prognosis. BMC Cancer 13:107
Thomas X, Archimbaud E, Charrin C, Magaud JP, Fiere D (1995) CD34 expression is associated with major adverse prognostic factors in adult acute lymphoblastic leukemia. Leukemia 9:249–253
Plesa C, Chelghoum Y, Plesa A, Elhamri M, Tigaud I, Michallet M et al (2008) Prognostic value of immunophenotyping in elderly patients with acute myeloid leukemia. Cancer 112:572–580
Pratcorona M, Brunet S, Nomdedéu J, Ribera JM, Tormo M, Duarte R et al (2013) Favorable outcome of patients with acute myeloid leukemia harboring a low-allelic burden FLT3-ITD mutation and concomitant NPM1 mutation: relevance to post-remission therapy. Blood 121:2734–2738
Juncà J, García-Caro M, Granada I, Rodríguez-Hernández I, Torrent A, Morgades M, Ribera JM, Millá F, Feliu E et al (2014) Correlation of CD11b and CD56 expression in adult acute myeloid leukemia with cytogenetic risk groups and prognosis. Ann Hematol 93:1483–1489
Peterlin P, Renneville A, Ben Abdelali R, Nibourel O, Thomas X, Pautas C et al (2015) Impact of additional genetic alterations on the outcome of patients with NPM1-mutated cytogenetically normal acute myeloid leukemia. Haematologica 100:e196–199. doi:10.3324/haematol.2014.115576
Acknowledgments
We would like to acknowledge the Institut Josep Carreras for its contribution in everyday support in the diagnosis and outcome evaluation of our patients.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Juncà, J., Garcia, O., Garcia-Caro, M. et al. CD34 expression and the outcome of nucleophosmin 1-mutated acute myeloid leukemia. Ann Hematol 95, 1949–1954 (2016). https://doi.org/10.1007/s00277-016-2811-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00277-016-2811-y