title: Clinical significance of CD56 expression in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline-based regimens.
abstract: The expression of CD56 antigen in acute promyelocytic leukemia (APL) blasts has been associated with short remission duration and extramedullary relapse. We investigated the clinical significance of CD56 expression in a large series of patients with APL treated with all-trans retinoic acid and anthracycline-based regimens. Between 1996 and 2009, 651 APL patients with available data on CD56 expression were included in 3 subsequent trials (PETHEMA LPA96 and LPA99 and PETHEMA/HOVON LPA2005). Seventy-two patients (11%) were CD56(+) (expression of CD56 in ≥ 20% leukemic promyelocytes). CD56(+) APL was significantly associated with high white blood cell counts; low albumin levels; BCR3 isoform; and the coexpression of CD2, CD34, CD7, HLA-DR, CD15, and CD117 antigens. For CD56(+) APL, the 5-year relapse rate was 22%, compared with a 10% relapse rate for CD56(-) APL (P = .006). In the multivariate analysis, CD56 expression retained the statistical significance together with the relapse-risk score. CD56(+) APL also showed a greater risk of extramedullary relapse (P < .001). In summary, CD56 expression is associated with the coexpression of immaturity-associated and T-cell antigens and is an independent adverse prognostic factor for relapse in patients with APL treated with all-trans-retinoic acid plus idarubicin-derived regimens. This marker may be considered for implementing risk-adapted therapeutic strategies in APL. The LPA2005 trial is registered at http://www.clinicaltrials.gov as NCT00408278.
authors.affiliation: Hospital Universitario La Fe, Valencia, Spain.
authors.forename: Pau
authors.initials: P
authors.lastname: Montesinos
authors.forename: Chelo
authors.initials: C
authors.lastname: Rayón
authors.forename: Edo
authors.initials: E
authors.lastname: Vellenga
authors.forename: Salut
authors.initials: S
authors.lastname: Brunet
authors.forename: José
authors.initials: J
authors.lastname: González
authors.forename: Marcos
authors.initials: M
authors.lastname: González
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Holowiecka
authors.forename: Jordi
authors.initials: J
authors.lastname: Esteve
authors.forename: Juan
authors.initials: J
authors.lastname: Bergua
authors.forename: José D
authors.initials: JD
authors.lastname: González
authors.forename: Concha
authors.initials: C
authors.lastname: Rivas
authors.forename: Mar
authors.initials: M
authors.lastname: Tormo
authors.forename: Vicente
authors.initials: V
authors.lastname: Rubio
authors.forename: Javier
authors.initials: J
authors.lastname: Bueno
authors.forename: Félix
authors.initials: F
authors.lastname: Manso
authors.forename: Gustavo
authors.initials: G
authors.lastname: Milone
authors.forename: Javier
authors.initials: J
authors.lastname: de la Serna
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Pérez
authors.forename: Manuel
authors.initials: M
authors.lastname: Pérez-Encinas
authors.forename: Isabel
authors.initials: I
authors.lastname: Krsnik
authors.forename: Josep M
authors.initials: JM
authors.lastname: Ribera
authors.forename: Lourdes
authors.initials: L
authors.lastname: Escoda
authors.forename: Bob
authors.initials: B
authors.lastname: Lowenberg
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Sanz
mesh_terms: D000293:Adolescent; D000328:Adult; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D019002:CD56 Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000097:blood / Q000188:drug therapy* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D014212:Tretinoin / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D019002:CD56 Antigen; C522918:NCAM1 protein, human; D014212:Tretinoin