FISH CD34 CD38- cells detected in newly diagnosed acute myeloid leukemia patients can predict the clinical outcomeReportar como inadecuado

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Journal of Hematology and Oncology

, 6:85

First Online: 07 November 2013Received: 30 July 2013Accepted: 16 October 2013DOI: 10.1186-1756-8722-6-85

Cite this article as: Wang, L., Gao, L., Xu, S. et al. J Hematol Oncol 2013 6: 85. doi:10.1186-1756-8722-6-85


BackgroundIn acute myeloid leukemia AML, the leukemia initiating cells LICs or leukemia stem cells LSCs is found within the CD34CD38 cell compartment. The LICs subpopulation survives chemotherapy and is most probable the cause of minimal residual disease MRD, which in turn is thought to cause relapse. The aim of this study was to determine the prognostic value of the percentage of LICs in blasts at diagnosis.

Design and methodsThe percentage of LICs in the blast population was determined at diagnosis using a unique Flow-FISH analysis, which applies fluorescent in situ hybridization FISH analysis on flow cytometry sorted cells to distinguish LICs within the CD34CD38 cell compartment. Fourty-five AML patients with FISH-detectable cytogenetic abnormalities treated with standardized treatment program were retrospectively included in the study. Correlations with overall survival OS, events-free survival EFS and cumulative incidence of relapse CIR were evaluated with univariate and multivariate analysis.

ResultsThe percentage of LICs is highly variable in patients with acute myeloid leukemia, ranged from 0.01% to 52.8% median, 2.1%. High LIC load ≥1% negatively affected overall survival 2-year OS: 72.57% vs. 16.75%; P = 0.0037 and events-free survival 2-year EFS: 67.23% vs. 16.33%; P = 0.0018, which was due to an increased cumulative incidence of relapse 2-year CIR: 56.7% vs. 18.0%; P = 0.021. By multivariate analysis, high LIC load retained prognostic significance for OS and EFS.

ConclusionsIn the present study, we established the Flow-FISH protocol as a useful method to distinguish normal and leukemic cells within the CD34CD38 cell subpopulation. The high percentage of LICs at diagnosis was significantly correlated with increased risk of poor clinical outcome.

KeywordsAcute myeloid leukemia Leukemia initiating cells Minimal residual disease Electronic supplementary materialThe online version of this article doi:10.1186-1756-8722-6-85 contains supplementary material, which is available to authorized users.

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Autor: Libing Wang - Lei Gao - Sheng Xu - Shenglan Gong - Li Chen - Shuqing Lü - Jie Chen - Huiying Qiu - Xiaoqian Xu - Xiong 


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