Adverse prognostic impact of CD36 and CD2 expression in adult de novo acute myeloid leukemia patients.
OBJECTIVE
A consecutive series of acute myeloid leukemias (AML) patients was analyzed in conditions which reduce the inter-assay variations (the same flow cytometer, the same observers and the same panel of monoclonal antibodies) in order to investigate the prognostic information provided by flow cytometry.


METHODS
Two hundred and sixty-six bone marrow (BM) samples from 326 patients enrolled in the LMA-99 protocol from the CETLAM group were studied by multiparametric flow cytometry. Immunophenotyping studies were performed on erythrocyte-lysed BM samples. Antigen expression of leukemic cells was analyzed using triple stainings with fluorochrome-conjugated combinations of monoclonal antibodies.


RESULTS
CD2 was positive in 21 cases (8%); an associated inv(16) was detected in eight CD2+ cases (38%). Two-year overall survival (OS) rate for CD2+/inv(16)+ patients was 75%, whereas it was 0% for CD2+/inv(16)- patients and 47% for CD2- patients (p=0.0001). CD36 was expressed in 37% of patients (n=98). Two-year leukemia-free survival (LFS) rate was 34% for CD36+ patients and 55% for CD36- patients (p=0.001). In the multivariate analysis, CD2+ (RR=8.4; p=0.0001) and adverse karyotype (RR=10.2; p=0.0001) were associated with a lower CR rate, CD36+ (RR=1.5; p=0.03), CD2+ (RR=2; p=0.04) and adverse karyotype (RR=4; p=0.0001) were associated with a lower OS and CD36+ (RR=2; p=0.002) and adverse karyotype (RR=3.5; p=0.005) predicted a lower LFS.


CONCLUSIONS
CD2+ patients had a very poor OS when CD2/inv(16)+ cases were excluded. CD36 and CD2 expression at diagnosis can provide prognostically important information in adult de novo AML.
Perea
G
G
Laboratori d'Hematologia, Hospital de la Santa Creu i Sant Pau, Avda Sant Antoni M. Claret, 167, 08025 Barcelona, Spain.
Domingo
A
A
Villamor
N
N
Palacios
C
C
Juncà
J
J
Torres
P
P
Llorente
A
A
Fernández
C
C
Tormo
M
M
Queipo de Llano
M P
MP
Bargay
J
J
Gallart
M
M
Florensa
L
L
Vivancos
P
P
Martí
J M
JM
Font
Ll
L
Berlanga
J
J
Esteve
J
J
Bueno
J
J
Ribera
J M
JM
Brunet
S
S
Sierra
J
J
Nomdedéu
J F
JF
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D018801:CD2 Antigens / Q000378:metabolism*; D018955:CD36 Antigens / Q000378:metabolism*; D002869:Chromosome Aberrations; D007446:Chromosome Inversion; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D007621:Karyotyping; D007951:Leukemia, Myeloid / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate
D000911:Antibodies, Monoclonal; D018801:CD2 Antigens; D018955:CD36 Antigens