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KMID : 0981820070270050313
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Korean Journal of Laboratory Medicine
2007 Volume.27 No. 5 p.313 ~ p.317
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Characteristics of Acute Myeloid Leukemia without HLA-DR Expression
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Moon Hee-won
Lee Sook-Younk
Huh Jung-Sik
Chung Wha-Soon
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Abstract
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Background : HLA-DR negativity is known to be useful for distinguishing acute promyelocytic leukemia (APL) from other subtypes of AML, but non-APL cases without HLA-DR antigen expression have been reported. The purpose of this study was to evaluate and compare the characteristics of APL, HLA-DR negative non-APL, and HLA-DR positive non-APL cases.
Methods : A total of 114 cases of AML admitted at Ewha Womans University, Mokdong Hospital between March 1997 and June 2006 were included in this study. A diagnosis of AML was made based on the results of morphology, cytochemistry, immunophenotype, cytogenetics, and/or fluorescence in situ hybridization.
Results : Among the 114 AML patients, HLA-DR antigen was not expressed in 39 (34%), including 24 non-APL (62%) and 15 APL patients (38%). The HLA-DR negative non-APL group showed higher leukocyte counts and positive rate of CD19 expression than did APL group (P<0.05). The remaining laboratory findings were not statistically different between the HLA-DR negative non-APL and APL groups. CD34 expression was more frequent in the HLA-DR positive non-APL group than in the HLA-DR negative non-APL group and APL group. Of the 24 patients with HLA-DR negative
non-APL, 7 patients had disseminated intravascular coagulation and 2 patients showed morphologic features similar to those of APL.
Conclusions : CD19 expression and leukocyte count may be helpful for differentiating HLA-DR negative non-APL from APL. However, the final diagnosis and classification should be confirmed by cytogenetic or molecular studies.
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KEYWORD
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HLA-DR negative, Immunophenotype, AML, Acute promyelocytic leukemia
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