TY - JOUR
T1 - Low expression of the myeloid differentiation antigens CD65s, a feature of poorly differentiated AML in older adults
T2 - Study of 711 patients enrolled in ECOG trials
AU - Paietta, E.
AU - Neuberg, D.
AU - Bennett, J. M.
AU - Dewald, G.
AU - Rowe, J. M.
AU - Cassileth, P. A.
AU - Cripe, L.
AU - Tallman, M. S.
AU - Wiernik, P. H.
N1 - Funding Information:
This work was supported by NCI, DHHS grants CA21115, CA23318, CA11083, and the Chemotherapy Foundation. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.
PY - 2003/8/1
Y1 - 2003/8/1
N2 - CD65s appears when the progenitor antigen CD34 disappears, suggesting that this sialylated carbohydrate antigen marks a turning point in normal myeloid differentiation. We characterized acute myeloid leukemia (AML) with low CD65s expression (CD65slow AML) in 711 patients entered on seven Eastern Cooperative Oncology Group AML treatment trials (1986-1999). Of those, 198 (28%) qualified as having CD65slow AML. Morphologically, CD65slow AML was more common in FAB subgroups with minimal differentiation, M0/M1 (P = <0.0001). Early precursor antigens CD34, CD117 and terminal transferase were more frequent in CD65slow than CD65shigh AML (P = <0.0001). Myeloperoxidase was present in fewer CD65slow myeloblasts, and the more mature myeloid antigens, CD15 and CD11b, were rarely detected (P = <0.0001). Yet, the two diagnoses did not differ in the distribution of cytogenetic prognostic groups or the occurrence of the multidrug-resistance mediator, P-glycoprotein. CD65slow AML patients were significantly older than CD65shigh cases (P<0.0001). Furthermore, the incidence of CD65slow cases increased with age, from 20% in patients under the age of 50 years to 67% in patients older than 80 years (P<0.0001). Overall, complete remission (CR) rate and overall survival were comparable in CD65slow and CD65shigh AML. However, among patients >55 years of age, CD65slow AML had a decreased CR rate of 33 vs 44% in CD65shigh AML (P=0.055). Thus, CD65slow AML represents immunophenotypically undifferentiated disease and occurs predominantly in older adults. Although not statistically significant, the observed association between low CD65s expression and decreased CR rate only in patients over the age of 55 is intriguing.
AB - CD65s appears when the progenitor antigen CD34 disappears, suggesting that this sialylated carbohydrate antigen marks a turning point in normal myeloid differentiation. We characterized acute myeloid leukemia (AML) with low CD65s expression (CD65slow AML) in 711 patients entered on seven Eastern Cooperative Oncology Group AML treatment trials (1986-1999). Of those, 198 (28%) qualified as having CD65slow AML. Morphologically, CD65slow AML was more common in FAB subgroups with minimal differentiation, M0/M1 (P = <0.0001). Early precursor antigens CD34, CD117 and terminal transferase were more frequent in CD65slow than CD65shigh AML (P = <0.0001). Myeloperoxidase was present in fewer CD65slow myeloblasts, and the more mature myeloid antigens, CD15 and CD11b, were rarely detected (P = <0.0001). Yet, the two diagnoses did not differ in the distribution of cytogenetic prognostic groups or the occurrence of the multidrug-resistance mediator, P-glycoprotein. CD65slow AML patients were significantly older than CD65shigh cases (P<0.0001). Furthermore, the incidence of CD65slow cases increased with age, from 20% in patients under the age of 50 years to 67% in patients older than 80 years (P<0.0001). Overall, complete remission (CR) rate and overall survival were comparable in CD65slow and CD65shigh AML. However, among patients >55 years of age, CD65slow AML had a decreased CR rate of 33 vs 44% in CD65shigh AML (P=0.055). Thus, CD65slow AML represents immunophenotypically undifferentiated disease and occurs predominantly in older adults. Although not statistically significant, the observed association between low CD65s expression and decreased CR rate only in patients over the age of 55 is intriguing.
KW - AML in the elderly
KW - CD65s
KW - Immunophenotype
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U2 - 10.1038/sj.leu.2402999
DO - 10.1038/sj.leu.2402999
M3 - Article
C2 - 12886241
AN - SCOPUS:0041525832
SN - 0887-6924
VL - 17
SP - 1544
EP - 1550
JO - Leukemia
JF - Leukemia
IS - 8
ER -