Expression of unusual immunophenotype combinations in acute myelogenous leukemia

C. L. Reading, E. H. Estey, Y. O. Huh, David Claxton, G. Sanchez, L. W.M.M. Terstappen, M. C. O'Brien, S. Baron, A. B. Deisseroth

Research output: Contribution to journalArticle

163 Citations (Scopus)

Abstract

Immunophenotypes for 272 patients with acute myelogenous leukemia (AML) were analyzed using a panel of 22 antibodies. Numerical evidence for unusual coexpressions (present in normal marrow at ≤0.1%) of surface markers on ≥10% of the blast cells was found in 85% of all cases. Asynchronous expression of myeloid differentiation antigens occurred in 70% of the cases. Unusual coexpression of T-lymphoid, B-lymphoid, or natural killer (NK) markers with myeloid markers occurred in 38%, 13%, and 21%, respectively, of all AML cases. Two- and three-color analyses confirmed coexpression in 15 of 15 cases, and indicated that these percentages are an underestimate, because coexpression can be demonstrated in cases without numerical overlap. These data indicate that the unusual coexpression of normal differentiation antigens is a common occurrence in AML. Markers in 12 of 13 patients were similar between presentation and relapse, and in two patients, unusual phenotypes detected at first relapse were shown at second relapse, indicating these immunophenotypes are stable in the majority of AML patients. Significant correlations were found between t(8;21) cytogenetics and coexpression of CD19 with CD15 or CD34, t(9;22) and coexpression of CD19 and CD34, and t(15;17) and coexpression of CD2 and myeloid antigens. Multiparameter fluorescence analysis allows detection of unusual phenotypes when the blast counts are < 5% (classical remission). Analysis of 16 patients in remission indicated the presence of presentation phenotypes in 0.2% to 7.9% of the lymphocyte + blast light scatter region, representing 0.03% to 1.4% of the total nucleated marrow cells. Of the 16 patients with ≥4 months follow-up after detection of these cells, 6 of 6 patients with ≥0.2% unusual presentation phenotypic marrow cells have relapsed, while 9 of 10 patients with < 0.2% remain in remission. The detection of cells with the unusual presentation phenotype may reflect residual AML cells, and their increase may predict relapse.

Original languageEnglish (US)
Pages (from-to)3083-3090
Number of pages8
JournalBlood
Volume81
Issue number11
StatePublished - Jan 1 1993

Fingerprint

Differentiation Antigens
Acute Myeloid Leukemia
Cells
Color
Lymphocytes
Fluorescence
Phenotype
Antigens
Recurrence
Antibodies
Bone Marrow
CD2 Antigens
Cytogenetics
Light

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Reading, C. L., Estey, E. H., Huh, Y. O., Claxton, D., Sanchez, G., Terstappen, L. W. M. M., ... Deisseroth, A. B. (1993). Expression of unusual immunophenotype combinations in acute myelogenous leukemia. Blood, 81(11), 3083-3090.
Reading, C. L. ; Estey, E. H. ; Huh, Y. O. ; Claxton, David ; Sanchez, G. ; Terstappen, L. W.M.M. ; O'Brien, M. C. ; Baron, S. ; Deisseroth, A. B. / Expression of unusual immunophenotype combinations in acute myelogenous leukemia. In: Blood. 1993 ; Vol. 81, No. 11. pp. 3083-3090.
@article{91cfc7ce65a9490fad27792b345ae245,
title = "Expression of unusual immunophenotype combinations in acute myelogenous leukemia",
abstract = "Immunophenotypes for 272 patients with acute myelogenous leukemia (AML) were analyzed using a panel of 22 antibodies. Numerical evidence for unusual coexpressions (present in normal marrow at ≤0.1{\%}) of surface markers on ≥10{\%} of the blast cells was found in 85{\%} of all cases. Asynchronous expression of myeloid differentiation antigens occurred in 70{\%} of the cases. Unusual coexpression of T-lymphoid, B-lymphoid, or natural killer (NK) markers with myeloid markers occurred in 38{\%}, 13{\%}, and 21{\%}, respectively, of all AML cases. Two- and three-color analyses confirmed coexpression in 15 of 15 cases, and indicated that these percentages are an underestimate, because coexpression can be demonstrated in cases without numerical overlap. These data indicate that the unusual coexpression of normal differentiation antigens is a common occurrence in AML. Markers in 12 of 13 patients were similar between presentation and relapse, and in two patients, unusual phenotypes detected at first relapse were shown at second relapse, indicating these immunophenotypes are stable in the majority of AML patients. Significant correlations were found between t(8;21) cytogenetics and coexpression of CD19 with CD15 or CD34, t(9;22) and coexpression of CD19 and CD34, and t(15;17) and coexpression of CD2 and myeloid antigens. Multiparameter fluorescence analysis allows detection of unusual phenotypes when the blast counts are < 5{\%} (classical remission). Analysis of 16 patients in remission indicated the presence of presentation phenotypes in 0.2{\%} to 7.9{\%} of the lymphocyte + blast light scatter region, representing 0.03{\%} to 1.4{\%} of the total nucleated marrow cells. Of the 16 patients with ≥4 months follow-up after detection of these cells, 6 of 6 patients with ≥0.2{\%} unusual presentation phenotypic marrow cells have relapsed, while 9 of 10 patients with < 0.2{\%} remain in remission. The detection of cells with the unusual presentation phenotype may reflect residual AML cells, and their increase may predict relapse.",
author = "Reading, {C. L.} and Estey, {E. H.} and Huh, {Y. O.} and David Claxton and G. Sanchez and Terstappen, {L. W.M.M.} and O'Brien, {M. C.} and S. Baron and Deisseroth, {A. B.}",
year = "1993",
month = "1",
day = "1",
language = "English (US)",
volume = "81",
pages = "3083--3090",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "11",

}

Reading, CL, Estey, EH, Huh, YO, Claxton, D, Sanchez, G, Terstappen, LWMM, O'Brien, MC, Baron, S & Deisseroth, AB 1993, 'Expression of unusual immunophenotype combinations in acute myelogenous leukemia', Blood, vol. 81, no. 11, pp. 3083-3090.

Expression of unusual immunophenotype combinations in acute myelogenous leukemia. / Reading, C. L.; Estey, E. H.; Huh, Y. O.; Claxton, David; Sanchez, G.; Terstappen, L. W.M.M.; O'Brien, M. C.; Baron, S.; Deisseroth, A. B.

In: Blood, Vol. 81, No. 11, 01.01.1993, p. 3083-3090.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Expression of unusual immunophenotype combinations in acute myelogenous leukemia

AU - Reading, C. L.

AU - Estey, E. H.

AU - Huh, Y. O.

AU - Claxton, David

AU - Sanchez, G.

AU - Terstappen, L. W.M.M.

AU - O'Brien, M. C.

AU - Baron, S.

AU - Deisseroth, A. B.

PY - 1993/1/1

Y1 - 1993/1/1

N2 - Immunophenotypes for 272 patients with acute myelogenous leukemia (AML) were analyzed using a panel of 22 antibodies. Numerical evidence for unusual coexpressions (present in normal marrow at ≤0.1%) of surface markers on ≥10% of the blast cells was found in 85% of all cases. Asynchronous expression of myeloid differentiation antigens occurred in 70% of the cases. Unusual coexpression of T-lymphoid, B-lymphoid, or natural killer (NK) markers with myeloid markers occurred in 38%, 13%, and 21%, respectively, of all AML cases. Two- and three-color analyses confirmed coexpression in 15 of 15 cases, and indicated that these percentages are an underestimate, because coexpression can be demonstrated in cases without numerical overlap. These data indicate that the unusual coexpression of normal differentiation antigens is a common occurrence in AML. Markers in 12 of 13 patients were similar between presentation and relapse, and in two patients, unusual phenotypes detected at first relapse were shown at second relapse, indicating these immunophenotypes are stable in the majority of AML patients. Significant correlations were found between t(8;21) cytogenetics and coexpression of CD19 with CD15 or CD34, t(9;22) and coexpression of CD19 and CD34, and t(15;17) and coexpression of CD2 and myeloid antigens. Multiparameter fluorescence analysis allows detection of unusual phenotypes when the blast counts are < 5% (classical remission). Analysis of 16 patients in remission indicated the presence of presentation phenotypes in 0.2% to 7.9% of the lymphocyte + blast light scatter region, representing 0.03% to 1.4% of the total nucleated marrow cells. Of the 16 patients with ≥4 months follow-up after detection of these cells, 6 of 6 patients with ≥0.2% unusual presentation phenotypic marrow cells have relapsed, while 9 of 10 patients with < 0.2% remain in remission. The detection of cells with the unusual presentation phenotype may reflect residual AML cells, and their increase may predict relapse.

AB - Immunophenotypes for 272 patients with acute myelogenous leukemia (AML) were analyzed using a panel of 22 antibodies. Numerical evidence for unusual coexpressions (present in normal marrow at ≤0.1%) of surface markers on ≥10% of the blast cells was found in 85% of all cases. Asynchronous expression of myeloid differentiation antigens occurred in 70% of the cases. Unusual coexpression of T-lymphoid, B-lymphoid, or natural killer (NK) markers with myeloid markers occurred in 38%, 13%, and 21%, respectively, of all AML cases. Two- and three-color analyses confirmed coexpression in 15 of 15 cases, and indicated that these percentages are an underestimate, because coexpression can be demonstrated in cases without numerical overlap. These data indicate that the unusual coexpression of normal differentiation antigens is a common occurrence in AML. Markers in 12 of 13 patients were similar between presentation and relapse, and in two patients, unusual phenotypes detected at first relapse were shown at second relapse, indicating these immunophenotypes are stable in the majority of AML patients. Significant correlations were found between t(8;21) cytogenetics and coexpression of CD19 with CD15 or CD34, t(9;22) and coexpression of CD19 and CD34, and t(15;17) and coexpression of CD2 and myeloid antigens. Multiparameter fluorescence analysis allows detection of unusual phenotypes when the blast counts are < 5% (classical remission). Analysis of 16 patients in remission indicated the presence of presentation phenotypes in 0.2% to 7.9% of the lymphocyte + blast light scatter region, representing 0.03% to 1.4% of the total nucleated marrow cells. Of the 16 patients with ≥4 months follow-up after detection of these cells, 6 of 6 patients with ≥0.2% unusual presentation phenotypic marrow cells have relapsed, while 9 of 10 patients with < 0.2% remain in remission. The detection of cells with the unusual presentation phenotype may reflect residual AML cells, and their increase may predict relapse.

UR - http://www.scopus.com/inward/record.url?scp=0027288164&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027288164&partnerID=8YFLogxK

M3 - Article

VL - 81

SP - 3083

EP - 3090

JO - Blood

JF - Blood

SN - 0006-4971

IS - 11

ER -

Reading CL, Estey EH, Huh YO, Claxton D, Sanchez G, Terstappen LWMM et al. Expression of unusual immunophenotype combinations in acute myelogenous leukemia. Blood. 1993 Jan 1;81(11):3083-3090.