Evaluation of the prognostic relevance of L-selectin and ICAM1 expression in myelodysplastic syndromes.
OBJECTIVE
An aberrant pattern of expression of L-selectin and intercellular adhesion molecule 1 (ICAM1) may characterise CD34+ blast cells in myelodysplastic syndromes (MDS) and secondary acute myeloid leukaemia (sAML).


METHODS
In a three-colour flow cytometric assay, we evaluated the expression of L-selectin and ICAM1 on CD34+ blast cells from the bone marrow (BM) of 66 MDS patients; for the purpose of comparison CD34+ blast cells of 18 sAML and CD34+ stem cells of 17 normal donors were also analysed.


RESULTS
The ratio of L-selectin/ICAM1 expression was identified as a parameter correlated with the percentage of BM blast infiltration and the time to leukaemic progression among MDS patients. In fact, the values of L-selectin/ICAM1 ratio were inversely correlated with the BM blast infiltration (r = -0.34, P = 0.004). Furthermore, MDS patients with a baseline ratio <1 had a higher leukaemic progression rate (41% vs. 19%, P = 0.008); the actuarial risk of disease progression for this subgroup of MDS patients was also higher (64% vs. 11% at 2 yr, P = 0.002). Furthermore, in two patients a decrease of the ratio was observed when overt leukaemic transformation occurred; conversely, restoration of a normal ratio was observed in two patients after a chemotherapy-induced remission.


CONCLUSIONS
(i) L-selectin is defective in the stem cell compartment of MDS and sAML, whereas ICAM1 is overexpressed; (ii) the ratio of their expression has a prognostic role; and (iii) a ratio <1 significantly predicts progression to overt leukaemia in MDS patients.
Buccisano
Francesco
F
Department of Biopatologia e Diagnostica per Immagini, Policlinico Tor Vergata and Ospedale S.Eugenio, Rome, Italy.
Maurillo
Luca
L
Tamburini
Anna
A
Del Poeta
Giovanni
G
Del Principe
Maria Ilaria
MI
Ammatuna
Emanuele
E
Consalvo
Maria Irno
MI
Campagna
Selenia
S
Ottaviani
Licia
L
Sarlo
Chiara
C
Renzi
Daniela
D
Faccia
Sabrina
S
Fraboni
Daniela
D
Lo Coco
Francesco
F
Amadori
Sergio
S
Venditti
Adriano
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000096:biosynthesis; D001853:Bone Marrow / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000096:biosynthesis* / Q000097:blood; D019041:L-Selectin / Q000096:biosynthesis* / Q000097:blood; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000378:metabolism*; D011379:Prognosis; D013997:Time Factors
D018952:Antigens, CD34; D018799:Intercellular Adhesion Molecule-1; D019041:L-Selectin