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CD34 immunohistochemistry of bone marrow biopsies: Prognostic significance in primary myelodysplastic syndromes
Author(s) -
Soligo Davide A.,
Oriani Alessandro,
Annaloro Claudio,
Cortelezzi Agostino,
Calori Rossella,
Pozzoli Ermanno,
Nosella Diego,
Orazi Attilio,
Deliliers Giorgio Lambertenghi
Publication year - 1994
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.2830460103
Subject(s) - cd34 , medicine , myelodysplastic syndromes , immunohistochemistry , bone marrow , pathology , stem cell , biology , genetics
Bone marrow (BM) biopsies from 58 patients with primary myelodysplastic syndrome (MDS) were studied using QBEND10, a monocional antibody that recognizes the human progenitor CD34 antigen in routine aldehyde‐fixed paraffin‐embedded samples. FAB subtypes were RA (5 patients), RARS (9 patients), RAEB (20 patients), RAEBt (11 patients), CMML (3 patients). In addition, 10 MDS patients whose BM biopsies revealed heavy reticulum fibrosis were included. Neither the percentage of CD34 + cells nor the number of CD34 + aggregates (defined as clusters of 3 or more cells) correlated with the presence and morphology of abnormal localizations of immature precursors (ALIP). When all patients were considered, median survival was 69 months in those with less, and 25 months in patients with more than 1% CD34 + cells ( P < 0.05). Median survival was 15 months in patients with CD34 + aggregates and 41 months in those without aggregates ( P = 0.0017). When RAEB patients were considered median survival was 41 months in those with less than 1%, and 29 months in those with more than 1% CD34 + cells; the 4‐year survival chance was 45% in the former and 18.3% in the latter group. Therefore, CD34 positivity of more than 1% identifies a subset of RAEB patients with shorter life expectancy. In addition, leukemic transformation was observed in 11 of 35 patients (31%) with no CD34 aggregates, but in 14 of 23 patients (60%) with aggregates ( P < 0.05). CD34 immunostaining, which can be easily performed on routinely prepared BM biopsies, was found to be a powerful prognostic tool for predicting survival and outcome in MDS. © 1994 Wiley‐Liss, Inc.