title: CD25 as an adverse prognostic factor in elderly patients with acute myeloid leukemia.
abstract: OBJECTIVE
  CD25 has been reported to be highly expressed in leukemia stem cells and correlated with adverse outcomes in young patients with acute myeloid leukemia (AML). However, the significance of CD25 expression in elderly patients with AML has not yet been investigated.
  
  
  METHODS
  We retrospectively analyzed 154 newly diagnosed AML patients aged 60 years or over by flow cytometry.
  
  
  RESULTS
  CD25-positive AML was characterized by high white blood cell counts, secondary AML, rare favorable karyotypes, and positivity for CD34 and CD7 antigens, compared with CD25-negative AML. CD25 positivity was significantly correlated with an inferior complete remission (CR), event-free survival (EFS), and overall survival. Multivariate analysis showed CD25 positivity to be a significant prognostic predictor of CR and EFS. A regimen of low-dose cytarabine and aclarubicin combined with granulocyte-colony-stimulating factor (CAG) led to higher CR rates in the CD25-positive AML patients than intensive chemotherapies. CD25 expression was increased at relapse and in the development of leukemic status from myelodysplastic syndrome or myeloproliferative neoplasm.
  
  
  CONCLUSIONS
  An effective treatment strategy for elderly patients with CD25-positive AML has not been established. Further studies are needed to evaluate the effect of a CAG regimen and allogenic stem cell transplantation in patients.
  
  
  CONCLUSIONS
  CD25 is an independent prognostic factor in elderly AML patients. Alternative therapies for CD25-positive elderly AML patients are needed.
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan.
authors.forename: Shin-Ichiro
authors.initials: SI
authors.lastname: Fujiwara
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan.|b Division of Cell Transplantation and Transfusion , Jichi Medical University , Tochigi , Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Muroi
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Yamamoto
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Hatano
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Okazuka
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sato
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan.
authors.forename: Iekuni
authors.initials: I
authors.lastname: Oh
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Ohmine
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan.
authors.forename: Keiya
authors.initials: K
authors.lastname: Ozawa
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D014408:Biomarkers, Tumor; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D053645:Interleukin-2 Receptor alpha Subunit / Q000235:genetics / Q000378:metabolism*; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D053645:Interleukin-2 Receptor alpha Subunit
keywords: AML; CD25; advanced age; flow cytometry; prognosis