title: Higher percentage of CD34 + CD38- cells detected by multiparameter flow cytometry from leukapheresis products predicts unsustained complete remission in acute myeloid leukemia.
abstract: Relapse in acute myeloid leukemia (AML) after chemotherapy reflects the persistence of resistant leukemia stem cells (LSCs). These cells have been described in the CD34 + CD38- cell fraction. Leukapheresis products were harvested in 123 patients in morphological complete remission and analyzed by multiparameter flow cytometry. The CD34 + CD38- cell population showed a prognostic impact on survival. Median event-free survival (EFS) was 8.2 months (3-year EFS: 29%) for those with a higher percentage of CD34 + CD38- versus 91.9 months (3-year EFS: 62%) for those with a lower percentage for the entire cohort. These differences were confirmed in patients undergoing autologous stem cell transplant, with median EFS of 7.3 months versus 91.1 months (3-year EFS: 31% vs. 70%). Higher proportions of CD34 + CD38- cells were associated with adverse cytogenetics and with earlier relapses. Higher percentages of CD34 + CD38- cells in apheresis products reflect inadequate in vivo purging and reliably distinguish samples enriched in LSCs from those involving mainly normal cells.
authors.affiliation: Laboratory of Hematology.
authors.forename: Adriana
authors.initials: A
authors.lastname: Plesa
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elhamri
authors.forename: Gilles
authors.initials: G
authors.lastname: Clapisson
authors.forename: Eve
authors.initials: E
authors.lastname: Mattei
authors.forename: Sophie
authors.initials: S
authors.lastname: Gazzo
authors.forename: Olivier
authors.initials: O
authors.lastname: Hequet
authors.forename: Isabelle
authors.initials: I
authors.lastname: Tigaud
authors.forename: Mauricette
authors.initials: M
authors.lastname: Michallet
authors.forename: Charles
authors.initials: C
authors.lastname: Dumontet
authors.forename: Xavier
authors.initials: X
authors.lastname: Thomas
mesh_terms: D051997:ADP-ribosyl Cyclase 1 / Q000097:blood*; D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000097:blood*; D018572:Disease-Free Survival; D005434:Flow Cytometry; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000401:mortality; D008875:Middle Aged; D014411:Neoplastic Stem Cells / Q000166:cytology; D012008:Recurrence
chemical_list: D018952:Antigens, CD34; D051997:ADP-ribosyl Cyclase 1
keywords: Acute myeloid leukemia; autologous transplant; leukemia stem cell; prognosis; stem cell harvest