Korean J Hematol.  2009 Jun;44(2):67-73. 10.5045/kjh.2009.44.2.67.

Clinical Significance of Co-expression of Aberrant Antigens in Acute Leukemia

• Jeong SH
• Lee HW
• Kang SY
• Ahn MS
• Hwang YH
• Choi JH
• Kim HC
• Cho SR
• Park JS

• KMID: 2252150
• DOI: http://doi.org/10.5045/kjh.2009.44.2.67

Abstract

BACKGROUND: Acute leukemias co-expressing myeloid and lymphoid antigens but does not meet the criteria for biphenotypic acute leukemia (BAL) is common, however its clinical significance is not fully defined.
METHODS
In this study, clinical features of 68 co-expressing (myeloid and lymphoid) acute leukemias diagnosed between January 2000 and December 2006 were studied and compared with those of a control group of patients (pure AML or ALL).
RESULTS
Age, gender, initial Lactate dehydrogenase (LDH) level and cytogenetics were not different between the co-expressing group and the control group. But, the initial bone marrow blast percent was significantly higher in the co-expressing group (70% vs. 54.5%, P=0.003). Fifty five percent (16/29) of ALL and 30% (52/172) of AML patients showed myeloid and lymphoid markers concomitantly. The lymphoid antigen positive AML (Ly+AML) patients showed significantly shorter survival rates than pure AML patients (4 year survival rate, 17.6% vs. 45.6%, P=0.002). However hematopoietic stem cell transplantation (HST) abrogated the difference (4 year survival rate, 54.7% vs. 50.6%, P=0.894). In ALL patients, survival rate was not affected by myeloid antigen co-expression (4 year survival rate 26.1% vs. 20%, P=0.954).
CONCLUSION
Co-expression of lymphoid markers in AML should be regarded as a poor prognostic factor and more aggressive treatment such as HST should be considered.

Keyword

Acute leukemia; Immunophenotyping; Co-expression; Prognosis

MeSH Terms

Bone Marrow
Cytogenetics
Hematopoietic Stem Cell Transplantation
Humans
Immunophenotyping
L-Lactate Dehydrogenase
Leukemia
Leukemia, Biphenotypic, Acute
Prognosis
Survival Rate
L-Lactate Dehydrogenase

Figure

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  Fig. 1. Survival of patients with co-expression against matched control. (A) Overall survival of AML patients, (B) Survival of AML patients without HST. (C) Survival of AML patients with HST. (D) Overall survival of ALL patients.

Reference

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