title: An immunophenotypic pre-treatment predictor for poor response to induction chemotherapy in older acute myeloid leukaemia patients: blood frequency of CD34+ CD38 low blasts.
abstract: Many older patients with acute myeloid leukaemia (AML) that receive standard intensive chemotherapy fail to achieve complete remission (CR). Upfront identification of patients unlikely to benefit from standard induction chemotherapy would be important for exploration of novel therapies. This study evaluated if a flow cytometric assay measuring pre-treatment CD34(+) CD38(low) blast frequency could predict therapeutic-resistance in 736 AML patients entered into the UK National Cancer Research Institute AML16 trial. High peripheral blood CD34(+) CD38(low) blast frequency (>7% of leucocytes), present in 18% of assessable patients, conferred significantly reduced CR rates (38% vs. 76%, P < 0.0001) and poor survival, and was independently prognostic for all endpoints of treatment resistance by multivariate analysis.
authors: Department of Clinical Immunology, University of Birmingham Medical School, Birmingham, UK.
authors: Naeem
authors: N
authors: Khan
authors: Department of Clinical Immunology, University of Birmingham Medical School, Birmingham, UK.
authors: Sylvie D
authors: SD
authors: Freeman
authors: Department of Immunology, North Bristol NHS Trust, Bristol, UK.
authors: Paul
authors: P
authors: Virgo
authors: Department of Haematology, University Hospital of Wales, Cardiff, UK.
authors: Steve
authors: S
authors: Couzens
authors: Department of Clinical Immunology, University of Birmingham Medical School, Birmingham, UK.
authors: Peter
authors: P
authors: Richardson
authors: Department of Haematology, Cardiff University School of Medicine, Cardiff, UK.
authors: Ian
authors: I
authors: Thomas
authors: Department of Haematology, Cardiff University School of Medicine, Cardiff, UK.
authors: Angela
authors: A
authors: Grech
authors: Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK.
authors: Paresh
authors: P
authors: Vyas
authors: Department of Medical and Molecular Genetics, Kings College London School of Medicine, Guy's & St. Thomas' NHS Foundation Trust, London, UK.
authors: David
authors: D
authors: Grimwade
authors: Department of Haematology, Nottingham University Hospital NHS Trust, Nottingham, UK.
authors: Nigel H
authors: NH
authors: Russell
authors: Department of Haematology, Cardiff University School of Medicine, Cardiff, UK.
authors: Alan K
authors: AK
authors: Burnett
authors: Department of Haematology, Cardiff University School of Medicine, Cardiff, UK.
authors: Robert K
authors: RK
authors: Hills
mesh_terms: D051997:ADP-ribosyl Cyclase 1 / Q000097:blood; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000097:blood; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D060828:Induction Chemotherapy; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D018952:Antigens, CD34; D051997:ADP-ribosyl Cyclase 1
keywords: acute myeloid leukaemia; flow cytometry; older patients; prognostic