Terminal transferase expression in acute myeloid leukaemia: Biology and prognosis

Rasim A. Gucalp, Elisabeth M. Paietta, V. Weinberg, P. Papenhausen, J. P. Dutcher, P. H. Wiernik

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Abstract

Clinical and biological features were assessed in 114 consecutive previously untreated adult acute myeloid leukaemia (AML) patients whose diagnosis was based on FAB criteria and detailed immunophenotyping. All patients received standard intensive chemotherapy. The main purpose of this study was to establish the prognostic value, if any, of terminal transferase (TdT) expression in myeloid leukaemia. TdT positive cells (7-80% of total blast cells) were detected in 40% of the cases. Among clinical characteristics, a low lactate dehydrogenase (LDH) (<250 I.U.) (P = 0.003), a low initial white blood cell count (<10 x 109/l) (P = 0.002), and an absolute neutrophil count (<5 x 109/l) (P = 0.02) were associated with TdT-positivity. FAB classification was not predictive of TdT expression, and there was no difference in the distribution of FAB subtypes between the groups. Multivariate analysis combining clinical and laboratory data indicated that a low expression of the monocytic antigen CD14 was predictive of TdT positivity in AML (P = 0.01). Karyotyping showed no difference in the pattern of occurrence of specific abnormalities between the TdT+ and the TdT- group. When clinical and immunophenotype data were included in a prognostic model, the patient's age was highly predictive of response (P<0.001), and only the CDw65 antigen contributed to the response model (P = 0.07). TdT+ patients with a low expression of CD11b achieved a higher frequency of response at a borderline level of significance (P = 0.06). Frequency of response to chemotherapy, the response duration or overall survival were not influenced by TdT expression.

Original languageEnglish (US)
Pages (from-to)48-54
Number of pages7
JournalBritish Journal of Haematology
Volume78
Issue number1
StatePublished - 1991

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Transferases
Acute Myeloid Leukemia
CD14 Antigens
Drug Therapy
Immunophenotyping
Karyotyping
Myeloid Leukemia
Leukocyte Count
L-Lactate Dehydrogenase
Neutrophils
Multivariate Analysis
Survival

ASJC Scopus subject areas

  • Hematology

Cite this

Terminal transferase expression in acute myeloid leukaemia : Biology and prognosis. / Gucalp, Rasim A.; Paietta, Elisabeth M.; Weinberg, V.; Papenhausen, P.; Dutcher, J. P.; Wiernik, P. H.

In: British Journal of Haematology, Vol. 78, No. 1, 1991, p. 48-54.

Research output: Contribution to journalArticle

Gucalp, RA, Paietta, EM, Weinberg, V, Papenhausen, P, Dutcher, JP & Wiernik, PH 1991, 'Terminal transferase expression in acute myeloid leukaemia: Biology and prognosis', British Journal of Haematology, vol. 78, no. 1, pp. 48-54.
Gucalp, Rasim A. ; Paietta, Elisabeth M. ; Weinberg, V. ; Papenhausen, P. ; Dutcher, J. P. ; Wiernik, P. H. / Terminal transferase expression in acute myeloid leukaemia : Biology and prognosis. In: British Journal of Haematology. 1991 ; Vol. 78, No. 1. pp. 48-54.
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