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Leukemia‐associated aberrant immunophenotype in patients with acute myeloid leukemia: changes at refractory disease or first relapse and clinicopathological findings
Author(s) -
Cui W.,
Zhang D.,
Cunningham M. T.,
Tilzer L.
Publication year - 2014
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/ijlh.12193
Subject(s) - immunophenotyping , myeloid leukemia , refractory (planetary science) , minimal residual disease , medicine , leukemia , cytogenetics , disease , oncology , myeloid , immunology , flow cytometry , cancer research , biology , gene , genetics , chromosome , astrobiology
Summary Introduction Multiparameter flow cytometry ( MFC ) is commonly used to detect minimal residual disease ( MRD ) during the course of chemotherapy or relapse. Only one study addressed the immunophenotypic changes in refractory disease. We studied changes in leukemia‐associated aberrant immunophenotype ( LAIP ) in patients with refractory and relapsed acute myeloid leukemia ( AML ). Method We analyzed 47 patients (refractory = 22; relapsed = 25) by MFC , morphology, and cytogenetic studies. Results Thirty‐five patients (74%) showed variably changed LAIP s. The frequently altered LAIP s were lack of lineage‐specific antigen and lineage infidelity. The most frequently changed marker was CD 13, followed by CD 33, CD 56, CD 7, CD 4, and CD 11b. Cytogenetic clonal evolution at persistence/relapse was observed in 15 patients (32%). Morphologically, three patients (6%) showed significant changes at relapse. Patients with refractory AML had a higher association with poor cytogenetic risk and classification of AML with myelodysplasia‐related changes. Positive MRD at postinduction was of prognostic significance. Allogeneic stem cell transplant improved overall survival. Conclusions LAIP alterations in refractory/relapsed AML s are common findings. Presence of persistent disease indicates a poor prognosis, regardless of cytogenetic risk or expression of CD 7 or CD 56. Discordance between cytogenetic and LAIP changes suggests that gross cytogenetic clonal evolution during disease progression only partly contributes to immunophenotypic instability.