title: Expression of CD56 is an unfavorable prognostic factor for acute promyelocytic leukemia with higher initial white blood cell counts.
abstract: Expression of CD56 has recently been introduced as one of the adverse prognostic factors in acute promyelocytic leukemia (APL). However, the clinical significance of CD56 antigen in APL has not been well elucidated. We assessed the clinical significance of CD56 antigen in 239 APL patients prospectively treated with all-trans retinoic acid and chemotherapy according to the Japan Adult Leukemia Study Group APL97 protocol. All patients were prospectively treated by the Japan Adult Leukemia Study Group APL97 protocol. The median follow-up period was 8.5 years. Positive CD56 expression was found in 23 APL patients (9.6%). Expression of CD56 was significantly associated with lower platelet count (P = 0.04), severe disseminated intravascular coagulation (P = 0.04), and coexpression of CD2 (P = 0.03), CD7 (P = 0.04), CD34 (P < 0.01) and/or human leukocyte antigen-DR (P < 0.01). Complete remission rate and overall survival were not different between the two groups. However, cumulative incidence of relapse and event-free survival (EFS) showed an inferior trend in CD56(+) APL (P = 0.08 and P = 0.08, respectively). Among patients with initial white blood cell counts of 3.0 × 10(9)/L or more, EFS and cumulative incidence of relapse in CD56(+) APL were significantly worse (30.8% vs 63.6%, P = 0.008, and 53.8% vs 28.9%, P = 0.03, respectively), and in multivariate analysis, CD56 expression was an unfavorable prognostic factor for EFS (P = 0.04). In conclusion, for APL with higher initial white blood cell counts, CD56 expression should be regarded as an unfavorable prognostic factor.
authors.affiliation: Department of Internal Medicine, School of Medicine, Hamamatsu University, Hamamatsu, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ono
authors.forename: Akihiro
authors.initials: A
authors.lastname: Takeshita
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kishimoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kiyoi
authors.forename: Masaya
authors.initials: M
authors.lastname: Okada
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamauchi
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Emi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Horikawa
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Matsuda
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shinagawa
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Monma
authors.forename: Shigeki
authors.initials: S
authors.lastname: Ohtake
authors.forename: Chiaki
authors.initials: C
authors.lastname: Nakaseko
authors.forename: Masatomo
authors.initials: M
authors.lastname: Takahashi
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Kimura
authors.forename: Masako
authors.initials: M
authors.lastname: Iwanaga
authors.forename: Norio
authors.initials: N
authors.lastname: Asou
authors.forename: Tomoki
authors.initials: T
authors.lastname: Naoe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D019002:CD56 Antigen / Q000096:biosynthesis* / Q000235:genetics; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D015473:Leukemia, Promyelocytic, Acute / Q000097:blood* / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000235:genetics / Q000473:pathology; D010976:Platelet Count; D011379:Prognosis; D011446:Prospective Studies; D012074:Remission Induction; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D019002:CD56 Antigen; C522918:NCAM1 protein, human; D003561:Cytarabine; D014212:Tretinoin; D015255:Idarubicin
keywords: Acute promyelocytic leukemia; CD56 expression; all‐trans retinoic acid; chemotherapy; prognostic factor