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KMID : 0366220090440020067
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Korean Journal of Hematology
2009 Volume.44 No. 2 p.67 ~ p.73
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Clinical Significance of Co-expression of Aberrant Antigens in Acute Leukemia
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Jeong Seong-Hyun
Park Joon-Seong
Choi Jin-Hyuk
Kim Hugh-Chul
Cho Sung-Ran
Lee Hyun-Woo
Kang Seok-Yun
Ahn Mi-Sun
Hwang Yoon-Ho
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Abstract
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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. (Korean J Hematol 2009;44:67-73.)
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KEYWORD
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Acute leukemia, Immunophenotyping, Co-expression, Prognosis
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