title: Lack of CD45 antigen on blast cells in childhood acute lymphoblastic leukemia is associated with chromosomal hyperdiploidy and other favorable prognostic features.
abstract: The leukocyte common antigen (CD45) was detected on the surface of leukemic cells in 217 (87%) of 249 cases of newly diagnosed childhood acute lymphoblastic leukemia (ALL). All 55 cases of T-lineage ALL, compared with 159 of 191 B-lineage cases, expressed the CD45 antigen (P = .0005). The frequency of CD45 expression did not differ between cases of early pre-B (CD19+, cytoplasmic mu-) and pre-B (CD19+, cytoplasmic mu+) ALL. Cases of ALL lacking CD45 had significantly lower leukocyte counts (P = .002) and serum lactic dehydrogenase (LDH) levels (P = .007) and were more likely to have leukemic cell hyperdiploidy greater than 50 (P less than .0001) or a DNA index greater than 1.15 (P less than .0001), as compared with cases positive for the antigen. Of the 130 patients whose follow-up duration was sufficient for analysis of event-free survival, the 53 with the highest levels of CD45 expression (greater than or equal to 90%) were the most likely to have an adverse event on intensive multiagent chemotherapy. Patients without detectable CD45 had a negligible risk of failure. This study suggests a relationship between the expression of the CD45 antigen on leukemic lymphoblasts and other biologic factors that influence prognosis in ALL.
authors.affiliation: Department of Pathology and Laboratory Medicine, St. Jude Children's Research Hospital, Memphis, TN 38101.
authors.forename: F G
authors.initials: FG
authors.lastname: Behm
authors.forename: S C
authors.initials: SC
authors.lastname: Raimondi
authors.forename: M J
authors.initials: MJ
authors.lastname: Schell
authors.forename: A T
authors.initials: AT
authors.lastname: Look
authors.forename: G K
authors.initials: GK
authors.lastname: Rivera
authors.forename: C H
authors.initials: CH
authors.lastname: Pui
mesh_terms: D015703:Antigens, CD / Q000032:analysis*; D002051:Burkitt Lymphoma / Q000235:genetics / Q000276:immunology; D002648:Child; D004171:Diploidy; D006649:Histocompatibility Antigens / Q000032:analysis*; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000235:genetics / Q000276:immunology; D017493:Leukocyte Common Antigens; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000276:immunology; D011379:Prognosis
chemical_list: D015703:Antigens, CD; D006649:Histocompatibility Antigens; D017493:Leukocyte Common Antigens