title: Biphasic expression of CD4 in acute myelocytic leukemia (AML) cells: AML of monocyte origin and hematopoietic precursor cell origin.
abstract: In 227 of 495 (45.9%) Japanese adult patients with acute myelocytic leukemia (AML), leukemic cells expressed CD4. Incidence of CD4 expression in each FAB subtype was as follows: M1 37.4%, M2 33.7%, M3 35.4%, M4 65.0%, and M5 78.3%. The typical expression pattern of myelomonocytic differentiation antigens and cytokine receptors in CD4+ AML was CD34lowCD33high CD11bhighGM-CSFRhigh. AML cases with 11q23 abnormalities and with inv(16) were frequently CD4-positive. These data collectively indicate that CD4 expression in AML cells is associated with monocytic characteristics. However, CD4+CD34high AML cases appear to have unique immature characteristics including low expression of myelomonocytic differentiation antigens (ie CD33 and CD11b), and accumulation of chromosome abnormalities (ie t(8;21) in CD4lowCD34high AML and chromosome 7 abnormalities in CD4highCD34high AML). We speculate that these leukemia subsets originate from CD4+ hematopoietic precursor cells, therefore then should be considered separately from most of the CD4+ AML as represented by CD34lowCD33high CD11bhighGM-CSFRhigh. Overall survival of patients with CD4+ AML in our series was worse than that of those with CD4 AML (P = 0.0202).
authors.affiliation: Second Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Miwa
authors.forename: M
authors.initials: M
authors.lastname: Mizutani
authors.forename: N
authors.initials: N
authors.lastname: Mahmud
authors.forename: M
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: M
authors.initials: M
authors.lastname: Shikami
authors.forename: H
authors.initials: H
authors.lastname: Shiku
authors.forename: I
authors.initials: I
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Nakase
authors.forename: K
authors.initials: K
authors.lastname: Nasu
authors.forename: H
authors.initials: H
authors.lastname: Dohy
authors.forename: T
authors.initials: T
authors.lastname: Ueda
authors.forename: N
authors.initials: N
authors.lastname: Kamada
authors.forename: K
authors.initials: K
authors.lastname: Kita
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000096:biosynthesis* / Q000097:blood; D015704:CD4 Antigens / Q000096:biosynthesis* / Q000097:blood; D002869:Chromosome Aberrations; D002872:Chromosome Deletion; D025063:Chromosome Disorders; D007446:Chromosome Inversion; D002880:Chromosomes, Human, Pair 11; D005260:Female; D006684:HLA-DR Antigens / Q000097:blood; D006412:Hematopoietic Stem Cells / Q000276:immunology*; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000235:genetics* / Q000276:immunology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology*; D015996:Survival Rate; D014178:Translocation, Genetic
chemical_list: D015703:Antigens, CD; D015704:CD4 Antigens; D006684:HLA-DR Antigens