CD34/CD117 positivity in assessment of prognosis in children with myelodysplastic syndrome.
Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal stem cell disorders that are characterized by morphology identifying dysplastic changes in one or more cell lineages, peripheral blood cytopenias and a propensity to evolve into secondary acute myeloid leukemia (AML). CD34 is commonly expressed in all types of childhood leukemias, whereas CD117 is a reliable and specific marker to detect leukemia cells committed to myeloid lineage. Co-expression of CD34/CD117 may strongly suggest the diagnosis of AML (Rytting ME. Pediatric myelodysplastic syndromes. Curr hematol Rep 2004;3(3):173-7. May; Uçkan D, Hiçsönmez G, Yetgin S, Gürgey A, Cetin M, Karaağaoğlu E, et al. CD34/CD117 co-expression in childhood acute leukemia. Leukemia Res 2000;24:201-6.). We describe the case of a 22 month-old-girl with MDS and Down syndrome who was presented with severe anemia and thrombocytosis at diagnosis, transformed into AML-M7. In our patient, CD34 and CD117 markers were positive on the blast cells of the BM 6 months before the chemotherapy decision. As the disease progressed, CD34/117 co-existence was increased and MDS transformed into AML. As a result, an increase in CD34 and CD117 positivity of the BM blast cells may be associated with a higher risk of leukemic transformation.
Tavil
Betul
B
Pediatric Hematolog Unit, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey. betultavil@yahoo.com
Cetin
Mualla
M
Tuncer
Murat
M
D018952:Antigens, CD34 / Q000032:analysis*; D001856:Bone Marrow Examination; D005260:Female; D006801:Humans; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000209:etiology; D009190:Myelodysplastic Syndromes / Q000150:complications* / Q000276:immunology; D011379:Prognosis; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis*
D018952:Antigens, CD34; D019009:Proto-Oncogene Proteins c-kit