title: Evaluation of the prognostic relevance of L-selectin and ICAM1 expression in myelodysplastic syndromes.
abstract: 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.
authors.affiliation: Department of Biopatologia e Diagnostica per Immagini, Policlinico Tor Vergata and Ospedale S.Eugenio, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Buccisano
authors.forename: Luca
authors.initials: L
authors.lastname: Maurillo
authors.forename: Anna
authors.initials: A
authors.lastname: Tamburini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Del Poeta
authors.forename: Maria Ilaria
authors.initials: MI
authors.lastname: Del Principe
authors.forename: Emanuele
authors.initials: E
authors.lastname: Ammatuna
authors.forename: Maria Irno
authors.initials: MI
authors.lastname: Consalvo
authors.forename: Selenia
authors.initials: S
authors.lastname: Campagna
authors.forename: Licia
authors.initials: L
authors.lastname: Ottaviani
authors.forename: Chiara
authors.initials: C
authors.lastname: Sarlo
authors.forename: Daniela
authors.initials: D
authors.lastname: Renzi
authors.forename: Sabrina
authors.initials: S
authors.lastname: Faccia
authors.forename: Daniela
authors.initials: D
authors.lastname: Fraboni
authors.forename: Francesco
authors.initials: F
authors.lastname: Lo Coco
authors.forename: Sergio
authors.initials: S
authors.lastname: Amadori
authors.forename: Adriano
authors.initials: A
authors.lastname: Venditti
mesh_terms: 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
chemical_list: D018952:Antigens, CD34; D018799:Intercellular Adhesion Molecule-1; D019041:L-Selectin