title: Immunophenotypic profile of adult acute myeloid leukemia (AML): analysis of 267 cases in Thailand.
abstract: Little data exists in Thailand and other Southeast Asian countries regarding the biological characteristics of adult acute myeloid leukemia (AML). In this study, we performed a flow cytometric analysis of 267 Thai adult AML cases to delineate the pattern of leukemic cell surface antigens. Forty-eight cases (18%) were identified as acute promyelocytic leukemia (M3) and 219 cases as non-M3. The most frequent subtype of AML in Thailand was M1/M2 and the least frequent was M7. M3 immunophenotypes were characterized by their unique lack of expression of CD34 and HLA-DR as contrast to the high mean expression of 50% and 70%, respectively, in non-M3. Overall, 60% of cases expressed CD34. Aberrant lymphoid antigens were uniquely seen in specific subtypes of Thai AML, including CD19 (33% of non-M3 vs 23% of M3) and CD2 (12% of M3 vs 2% of non-M3). CD56 was frequently expressed in both M3 and non-M3 while CD16 appeared to be associated with M4/M5 (24% of cases) and CD7 with M1/M2 (21% of cases). Eighty-one percent of non-M3 expressed CD38 while only 53% of M3 did. We found that most Thai adult AML patients were on average 15-20 years younger than those of the West or Japan with only 25% of Thai cases over 60 years of age, although the immunophenotypes were not markedly different. Biological studies of acute leukemia in various countries should help to provide epidemiological clues that play a role in the pathogenesis of leukemia in different geographic regions of the world. Our study represents the largest series of AML ever investigated in the Southeast Asian region.
authors.affiliation: Division of Hematology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Chirayu Udomsakdi
authors.initials: CU
authors.lastname: Auewarakul
authors.forename: Orathai
authors.initials: O
authors.lastname: Promsuwicha
authors.forename: Yaowaluk
authors.initials: Y
authors.lastname: U-Pratya
authors.forename: Kovit
authors.initials: K
authors.lastname: Pattanapanyasat
authors.forename: Surapol
authors.initials: S
authors.lastname: Issaragrisil
mesh_terms: D000208:Acute Disease; D000328:Adult; D015703:Antigens, CD / Q000096:biosynthesis / Q000276:immunology; D000954:Antigens, Surface / Q000096:biosynthesis / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D002454:Cell Differentiation / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D006021:Glycophorins / Q000096:biosynthesis / Q000276:immunology; D042381:Granulocyte Precursor Cells / Q000166:cytology / Q000276:immunology; D006098:Granulocytes / Q000166:cytology / Q000276:immunology; D006454:Hemoglobins / Q000276:immunology / Q000378:metabolism; D006801:Humans; D016130:Immunophenotyping; D007951:Leukemia, Myeloid / Q000276:immunology*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D013223:Statistics as Topic; D013785:Thailand
chemical_list: D015703:Antigens, CD; D000954:Antigens, Surface; D015415:Biomarkers; D006021:Glycophorins; D006454:Hemoglobins