title: Acute myelogenous leukemia with t(8;21)--identification of a specific immunophenotype.
abstract: Association between certain surface markers and acute myelogenous leukemia (AML) with t(8;21) has been described. The specificity and the predictive values of these markers have never been assessed. In this study, we aimed, to explore whether a specific pattern could predict for this translocation. Of 405 consecutive AML, 18 (4.4%) had the t(8;21). Patients with this cytogenetic abnormality showed higher frequency of CD34 (P = 0.003), HLA-DR (P = 0.03), Tdt (P = 0.02), CD19 (P < 0.0001), and CD56 (P < 0.0001) and lower CD33 (P = 0.0001). Taken singly, the sensitivity of these markers for AML with t(8;21) ranged between 39 and 100% with CD34+ having the highest and CD33- having the lowest and the positive predictive values (PPV) ranged between 5 and 21% with CD19+ having the highest and HLA-DR+ having the lowest. When combinations of different markers were analyzed by multivariate analysis, the pattern CD34+/HLA-DR+/MPO+ was found to have the highest sensitivity (100%) with a PPV of 14% and the pattern CD34+/CD19+/CD56+ had the highest PPV (100%) with a sensitivity of 67%. We conclude that AML with t(8;21) is better identified by a combination of markers than by a single antigen pattern, the absence of CD34+, HLA-DR+ or MPO+ would preclude and the expression of the pattern CD34+/CD19+/CD56+ is highly predictive and could serve as a screening criteria for the t(8;21).
authors.affiliation: Leukemia/BMT Program of British Columbia, Vancouver, Canada. khaytham@uhnres.utoronto.ca
authors.forename: Haytham
authors.initials: H
authors.lastname: Khoury
authors.forename: Bakul I
authors.initials: BI
authors.lastname: Dalal
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Nevill
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Horsman
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Barnett
authors.forename: John D
authors.initials: JD
authors.lastname: Shepherd
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Toze
authors.forename: Ebhilin A
authors.initials: EA
authors.lastname: Conneally
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Sutherland
authors.forename: Donna E
authors.initials: DE
authors.lastname: Hogge
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Nantel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism*; D016022:Case-Control Studies; D002891:Chromosomes, Human, Pair 21 / Q000235:genetics*; D002898:Chromosomes, Human, Pair 8 / Q000235:genetics*; D004253:DNA Nucleotidylexotransferase / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D015973:Gene Expression Regulation, Leukemic; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D014178:Translocation, Genetic / Q000235:genetics*
chemical_list: D015703:Antigens, CD; D006684:HLA-DR Antigens; D004253:DNA Nucleotidylexotransferase