Abstract:
Flow cytometry-based immunophenotyping is a mainstay of diagnostics in acute myeloid leukaemia (AML). Aberrant CD56 and T-cell antigen expression is observed in a fraction subset of AML cases, but the clinical relevance remains incompletely understood. Here, we retrospectively investigated the association of CD56 and T-cell marker expression with disease-specific characteristics and outcome of 324 AML patients who received intensive induction therapy at our centre between 2011 and 2019. We found that CD2 expression was associated with abnormal non-complex karyotype, NPM1 wild-type status and TP53 mutation. CD2 also correlated with a lower complete remission (CR) rate (47.8% vs. 71.6%, p = 0.03). CyTdT and CD2 were associated with inferior 3-year event-free-survival (EFS) (5.3% vs. 33.5%, p = 0.003 and 17.4% vs. 33.1%, p = 0.02, respectively). CyTdT expression was also correlated with inferior relapse-free survival (27.3% vs. 48.8%, p = 0.04). In multivariable analyses CD2 positivity was an independent adverse factor for EFS (HR 1.72, p = 0.03). These results indicate a biological relevance of aberrant T-cell marker expression in AML and provide a rationale to further characterise the molecular origin in T-lineage-associated AML.
摘要:
基于流式细胞术的免疫分型是诊断急性髓性白血病(AML)的主要方法。在一部分AML病例中观察到异常CD56和T细胞抗原表达,但临床相关性仍未完全理解。这里,我们回顾性调查了CD56和T细胞标志物表达与疾病特异性特征和预后的相关性,纳入了2011年至2019年在我们中心接受强化诱导治疗的324例AML患者.我们发现CD2表达与非复杂核型异常有关,NPM1野生型状态和TP53突变。CD2还与较低的完全缓解(CR)率相关(47.8%vs.71.6%,p=0.03)。CyTdT和CD2与3年无事件生存率(EFS)相关(5.3%vs.33.5%,p=0.003和17.4%vs.33.1%,分别为p=0.02)。CyTdT表达也与无复发生存率低相关(27.3%vs.48.8%,p=0.04)。在多变量分析中,CD2阳性是EFS的独立不利因素(HR1.72,p=0.03)。这些结果表明AML中异常T细胞标志物表达的生物学相关性,并提供了进一步表征T谱系相关AML中分子起源的基本原理。