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Clinical and prognostic significance of in vivo differentiation in acute myeloid leukemia
Author(s) -
Raza Azra,
Preisler Harvey,
Lampkin Beatrice,
Lykins Joseph,
Kukla Cathy,
Gartside Peter,
Sheikh Yasin,
Yousuf Naveed,
White Michael,
Barcos Maurice,
Bennett John,
Browman George,
Goldberg Jack,
Grunwald Hans,
Larson Richard,
Vardiman James,
Vogler Ralph
Publication year - 1993
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830420202
Subject(s) - in vivo , bone marrow , myeloid leukemia , haematopoiesis , bromodeoxyuridine , myeloid , medicine , minimal residual disease , cytarabine , immunology , gastroenterology , cancer research , pathology , biology , stem cell , immunohistochemistry , genetics , microbiology and biotechnology
Bromodeoxyuridine (BrdU) was administered to 86 newly diagnosed patients with standard risk acute myeloid leukemia (AML) prior to starting induction therapy and the labeling index (LI), durations of S‐phase (Ts), and the cell cycle (Tc) of myeloblasts were determined. Induction therapy with cytosine arabinoside and daunomycin was subsequently started. Bone marrow biopsies were obtained on days 6 and 17 and weekly thereafter, and were treated with a monoclonal anti‐BrdU antibody to determine the fate of cells labeled on day 0 by BrdU. BrdU labeled granulocytes indicating the presence of in vivo differentiation (Diff+) were identified in 48 patients ranging from 1+ (1–10 labeled cells) to 4+ (greater than 31 labeled granulocytes). When compared to 38 differentiation negative (Diff‐) patients, Diff+ group had longer Ts (14.5 hr vs. 10.95 hr, P = 0.015) and Tc (59.7 hr vs. 41.7 hr, P = 0.017). Remission duration was significantly longer (no median) for 3–4+ Diff+ as compared to Diff‐ (median = 220 days) patients (Wilcoxon P = 0.04). We conclude that the detection of in vivo differentiation in AML patients indicates a favorable long‐term prognosis either due to the presence of a substantial amount of normal residual hematopoiesis prior to starting induction therapy or due to the ability of leukemic cells to undergo differentiation. © 1993 Wiley‐Liss, Inc.