Low expression of the myeloid differentiation antigens CD65s, a feature of poorly differentiated AML in older adults: Study of 711 patients enrolled in ECOG trials

Elisabeth M. Paietta, D. Neuberg, J. M. Bennett, G. Dewald, J. M. Rowe, P. A. Cassileth, L. Cripe, M. S. Tallman, P. H. Wiernik

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1544-1550
Number of pages7
JournalLeukemia
Volume17
Issue number8
DOIs
StatePublished - Aug 1 2003
Externally publishedYes

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Differentiation Antigens
Acute Myeloid Leukemia
CD34 Antigens
Carbohydrates
Antigens

Keywords

  • AML in the elderly
  • CD65s
  • Immunophenotype

ASJC Scopus subject areas

  • Hematology
  • Cancer Research

Cite this

Low expression of the myeloid differentiation antigens CD65s, a feature of poorly differentiated AML in older adults : Study of 711 patients enrolled in ECOG trials. / Paietta, Elisabeth M.; Neuberg, D.; Bennett, J. M.; Dewald, G.; Rowe, J. M.; Cassileth, P. A.; Cripe, L.; Tallman, M. S.; Wiernik, P. H.

In: Leukemia, Vol. 17, No. 8, 01.08.2003, p. 1544-1550.

Research output: Contribution to journalArticle

Paietta, Elisabeth M. ; Neuberg, D. ; Bennett, J. M. ; Dewald, G. ; Rowe, J. M. ; Cassileth, P. A. ; Cripe, L. ; Tallman, M. S. ; Wiernik, P. H. / Low expression of the myeloid differentiation antigens CD65s, a feature of poorly differentiated AML in older adults : Study of 711 patients enrolled in ECOG trials. In: Leukemia. 2003 ; Vol. 17, No. 8. pp. 1544-1550.
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abstract = "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.",
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