Complex measurements may be required to establish the prognostic impact of immunophenotypic markers in AML.
OBJECTIVE
The prognostic impact of immunophenotypic markers in acute myeloid leukemia (AML) is controversial.


METHODS
We retrospectively analyzed the value of CD34, CD117, CD7, and CD123 expression in a consecutive series of 592 adult patients with de novo AML.


RESULTS
CD34+ measured as a percentage (≥2.88%) and CD34 mean fluorescence intensity (MFI) (≥146.79, arbitrary units [AU]) expression had a prognostic impact in terms of overall survival (OS; P = .005, P = .003), leukemia-free survival (LFS; P = .011, P < .001), and cumulative incidence of relapse (CIR; P = .014, P =. 001). The percentage of CD117+ cells (61.29%) was associated with shorter LFS (P =. 043), and CD117 MFI (≥284.01 AU) was associated with a shorter OS (P =. 033) and LFS (P =. 028). In the multivariate analysis, high CD34 MFI retained the independent value as predictor of LFS and CIR (P =. 012; hazard ratio [HR], 1.59; 95% confidence interval [CI], 1.11-2.28 and P =. 045; HR, 1.58; 95% CI, 1.01-2.46).


CONCLUSIONS
CD34 positivity threshold with prognostic relevance is low (3% positive cells). Immunophenotypic findings in AML probably could only be fully exploited after a complex analysis that takes into account unconventional thresholds and the MFI.
From the Departments of Hematology and Laboratory and.
Maria Concepcion
MC
García-Dabrio
Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona, Spain;
Montserrat
M
Hoyos
Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona, Spain;
Salut
S
Brunet
Department of Hematology, Hospital Clínic, Valencia, Spain;
Mar
M
Tormo
Department of Hematology, Hospital ICO Germans Trias i Pujol, Badalona, Spain;
Josep-Maria
JM
Ribera
Department of Hematology, Hospital Clínic, IDIBAPS, Barcelona, Spain;
Jordi
J
Esteve
Department of Hematology, Hospital ICO Hospital Josep Trueta, Girona, Spain;
David
D
Gallardo
Department of Hematology, Hospital ICO Duran i Reynalds, L'Hospitalet, Barcelona, Spain;
Rafael F
RF
Duarte
Department of Hematology, Hospital Virgen de la Victoria, Malaga, Spain;
Maria Paz Queipo
MP
de Llano
Department of Hematology, Hospital Sont Llatzer, Palma de Mallorca, Spain;
Joan
J
Bargay
Department of Hematology, Hospital de la Mutua de Terrassa, Terrassa, Spain;
Josep M
JM
Martí-Tutusaus
Department of Hematology, Hospital Virgen de la Arrixaca, Murcia, Spain;
Inmaculada
I
Heras
Department of Hematology, Hospital Arnau de Vilanova, Lleida, Spain;
Antoni
A
Garcia
Department of Hematology, Hospital de la Vall d' Hebrón, Barcelona, Spain; and.
Olga
O
Salamero
From the Departments of Hematology and Laboratory and.
Anna
A
Aventin
Cancer Research Center (IBMCC, USAL-CSIC), Department of Medicine and Cytometry Service (NUCLEUS), University of Salamanca (USAL) and Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain, on behalf of the Spanish CETLAM Group.
Quentin
Q
Lecrevisse
Cancer Research Center (IBMCC, USAL-CSIC), Department of Medicine and Cytometry Service (NUCLEUS), University of Salamanca (USAL) and Institute for Biomedical Research of Salamanca (IBSAL), Salamanca, Spain, on behalf of the Spanish CETLAM Group.
Alberto
A
Orfao
Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona, Spain;
Jorge
J
Sierra
From the Departments of Hematology and Laboratory and jnomdedeu@santpau.cat.
Josep F
JF
Nomdedéu
D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis* / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006801:Humans; D016130:Immunophenotyping; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
D015703:Antigens, CD; D015415:Biomarkers
AML; Blast cell heterogeneity; Mean fluorescence intensity; Multiparameter flow cytometry; Prognosis