CD34 expression is associated with major adverse prognostic factors in adult acute lymphoblastic leukemia.
Seventy-five adult patients with newly diagnosed acute lymphoblastic leukemia (ALL) were analyzed for CD34 expression on leukemic cells. CD34 was significantly associated with B-cell lineage ALL (p = 0.0002). In B-lineage ALL, CD34 positivity was significantly associated with expressions of CD9 (p = 0.001), CD19 (p = 0.00001) and CD22 (p = 0.002). CD34 was more expressed in B-ALLs with higher WBC cell count (p = 0.04), and higher percentage of peripheral blood leukemic cells (p = 0.005), total or partial monosomy of chromosome 7 (p = 0.0001) or Ph+ chromosome (p = 0.01); and less expressed in cases with hyperdiploidy (> or = 50 chromosomes) (p = 0.03). CD34 was more expressed in poor risk B-ALLs patients, defined according to Hoelzer criteria (p = 0.01). In T-lineage ALL, CD34 positivity was inversely correlated with the expression of CD10 (p = 0.05). After intensive induction therapy, 58 of 73 evaluable patients (79%) achieved a complete remission (CR). CD34 positivity was correlated with the persistence of blast cells in day 15 bone marrow aspirates (p = 0.001) and after one course of induction chemotherapy (p = 0.01). With a median follow-up of 11 months, no statistical differences were seen in leukemia-free survival and overall survival between CD34 positive and negative cases, even when stratifying by immunophenotype. We conclude that CD34 expression is associated with features of poor prognosis in adult ALL. Its study might therefore become useful in the design of future prognostic models.
Thomas
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X
Service d'Hématologie, Hôpital Edouard Herriot, Lyon, France.
Archimbaud
E
E
Charrin
C
C
Magaud
J P
JP
Fiere
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000677:Amsacrine / Q000008:administration & dosage; D000782:Aneuploidy; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D015703:Antigens, CD / Q000032:analysis*; D018952:Antigens, CD34; D000951:Antigens, Neoplasm / Q000032:analysis*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001215:Asparaginase / Q000008:administration & dosage; D014408:Biomarkers, Tumor / Q000097:blood*; D016026:Bone Marrow Transplantation; D002051:Burkitt Lymphoma / Q000097:blood* / Q000235:genetics / Q000401:mortality; D002454:Cell Differentiation; D002869:Chromosome Aberrations; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D015993:Life Tables; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D014411:Neoplastic Stem Cells / Q000737:chemistry*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000235:genetics / Q000401:mortality / Q000628:therapy; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction; D012307:Risk Factors; D016879:Salvage Therapy; D016019:Survival Analysis; D014750:Vincristine / Q000008:administration & dosage
D000903:Antibiotics, Antineoplastic; D015703:Antigens, CD; D018952:Antigens, CD34; D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D000677:Amsacrine; D003561:Cytarabine; D014750:Vincristine; D003520:Cyclophosphamide; D001215:Asparaginase; D011241:Prednisone