The immunophenotype of 177 adults with acute myeloid leukemia: proposal ofa prognostic score

Citation
O. Legrand et al., The immunophenotype of 177 adults with acute myeloid leukemia: proposal ofa prognostic score, BLOOD, 96(3), 2000, pp. 870-877
Citations number
42
Categorie Soggetti
Hematology,"Cardiovascular & Hematology Research
Journal title
BLOOD
ISSN journal
00064971 → ACNP
Volume
96
Issue
3
Year of publication
2000
Pages
870 - 877
Database
ISI
SICI code
0006-4971(20000801)96:3<870:TIO1AW>2.0.ZU;2-R
Abstract
In acute myeloid leukemia (AML) patients, a variety of clinical and biologi c parameters, including phenotype, have been examined for potential value i n predicting treatment response and survival. The European Group for the Im munological Classification of Leukaemias (EGIL) has proposed that AML be de fined immunologically by the expression of 2 or more of the following myelo id markers: myeloperoxidase, CD13, CD33, CDw65, and CD117, With regard to t his classification, the prognostic significance of 21 antigens taken separa tely and with immunophenotypic subgroups were evaluated and compared with o ther clinical and biological variables in 177 adult AML patients. None of t he antigens tested were associated with treatment outcome. In contrast, pat ients with blasts disclosing a full expression of panmyeloid phenotype (def ined by the expression of all 5 myeloid markers) had a higher complete remi ssion rate (P < .0001) and differed significantly in disease-free survival (P = .02) and overall survival (P = .008) than patients whose cells express ed fewer than 5 of these markers. In multivariate analysis, only age, panmy eloid phenotype, performance status, and permeability glycoprotein activity influence treatment outcome, Cyto genetics was significant in univariate a nalysis but not in multivariate analysis, most likely because of the redund ancy with panmyeloid phenotype and a higher sensitivity of immunophenotypin g, Patients whose cells exhibit the panmyeloid phenotype appear to define a relatively homogeneous biological subset of AML, The 4 independent prognos tic factors were used to create a prognostic score, defined by the number o f factors present. This score permitted a stratification of patients with A ML, thereby allowing for the consideration of innovative therapies to impro ve outcome in the poorer outcome groups, (C) 2000 by The American Society o f Hematology.