Flow cytometric maturity score as a novel prognostic parameter in patients with acute myeloid leukemia
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Flow cytometric maturity score as a novel prognostic parameter in patients with acute myeloid leukemia. / Schneider, Tanja; Flörcken, Anne; Singh, Anju; Türkmen, Seval; Burmeister, Thomas; Anagnostopoulos, Ioannis; Pezzutto, Antonio; Dörken, Bernd; Westermann, Jörg.
in: ANN HEMATOL, Jahrgang 94, Nr. 8, 08.2015, S. 1337-45.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Flow cytometric maturity score as a novel prognostic parameter in patients with acute myeloid leukemia
AU - Schneider, Tanja
AU - Flörcken, Anne
AU - Singh, Anju
AU - Türkmen, Seval
AU - Burmeister, Thomas
AU - Anagnostopoulos, Ioannis
AU - Pezzutto, Antonio
AU - Dörken, Bernd
AU - Westermann, Jörg
PY - 2015/8
Y1 - 2015/8
N2 - The European LeukemiaNet (ELN) classification is widely accepted for risk stratification of patients with acute myeloid leukemia (AML). In order to establish immunophenotypic features that predict prognosis, the expression of single AML blast cell antigens has been evaluated with partly conflicting results; however, the influence of immunophenotypic blast maturity is largely unknown. In our study, 300 AML patients diagnosed at our institution between January 2003 and April 2012 were analyzed. A flow cytometric maturity score was developed in order to distinguish "mature" AML (AML-ma) from "immature" AML (AML-im) by quantitative expression levels of early progenitor cell antigens (CD34, CD117, and TdT). AML-ma showed significantly longer relapse-free survival (RFS) and overall survival (OS) than AML-im (p < 0.001). Interestingly, statistically significant differences in RFS and OS were maintained within the "intermediate-risk" group according to ELN (RFS, 7.0 years (AML-ma) vs. 3.3 years (AML-im); p = 0.002; OS, 5.1 years (AML-ma) vs. 3.0 years (AML-im); p = 0.022). Our novel flow cytometric score easily determines AML blast maturity and can predict clinical outcome. It remains to be clarified whether these results simply reflect an accumulation of favorable molecular phenotypes in the AML-ma subgroup or whether they rely on biological differences such as a higher proportion of leukemia stem cells and/or a higher degree of genetic instability within the AML-im subgroup.
AB - The European LeukemiaNet (ELN) classification is widely accepted for risk stratification of patients with acute myeloid leukemia (AML). In order to establish immunophenotypic features that predict prognosis, the expression of single AML blast cell antigens has been evaluated with partly conflicting results; however, the influence of immunophenotypic blast maturity is largely unknown. In our study, 300 AML patients diagnosed at our institution between January 2003 and April 2012 were analyzed. A flow cytometric maturity score was developed in order to distinguish "mature" AML (AML-ma) from "immature" AML (AML-im) by quantitative expression levels of early progenitor cell antigens (CD34, CD117, and TdT). AML-ma showed significantly longer relapse-free survival (RFS) and overall survival (OS) than AML-im (p < 0.001). Interestingly, statistically significant differences in RFS and OS were maintained within the "intermediate-risk" group according to ELN (RFS, 7.0 years (AML-ma) vs. 3.3 years (AML-im); p = 0.002; OS, 5.1 years (AML-ma) vs. 3.0 years (AML-im); p = 0.022). Our novel flow cytometric score easily determines AML blast maturity and can predict clinical outcome. It remains to be clarified whether these results simply reflect an accumulation of favorable molecular phenotypes in the AML-ma subgroup or whether they rely on biological differences such as a higher proportion of leukemia stem cells and/or a higher degree of genetic instability within the AML-im subgroup.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Female
KW - Flow Cytometry
KW - Humans
KW - Leukemia, Myeloid, Acute
KW - Male
KW - Middle Aged
KW - Neoplastic Stem Cells
KW - Prognosis
KW - Young Adult
U2 - 10.1007/s00277-015-2400-5
DO - 10.1007/s00277-015-2400-5
M3 - SCORING: Journal article
C2 - 25994787
VL - 94
SP - 1337
EP - 1345
JO - ANN HEMATOL
JF - ANN HEMATOL
SN - 0939-5555
IS - 8
ER -