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Hierarchical cluster analysis of immunophenotype classify AML patients with NPM1 gene mutation into two groups with distinct prognosis.
Chen, Chien-Yuan; Chou, Wen-Chien; Tsay, Woei; Tang, Jih-Luh; Yao, Ming; Huang, Sheng-Yi; Tien, Hwei-Fang.
Afiliação
  • Chen CY; Departments of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. chienyuanchen@ntu.edu.tw
BMC Cancer ; 13: 107, 2013 Mar 08.
Article em En | MEDLINE | ID: mdl-23496932
ABSTRACT

BACKGROUND:

The prognostic implication of immunophenotyping in acute myeloid leukemia (AML) patients with NPM1 mutation remains unclear.

METHODS:

Ninety-four of 543 AML patients diagnosed with NPM1 mutation between 1987 and 2007 were studied. The expression of surface antigens on leukemic cells was evaluated with respect to clinical manifestations and outcomes. In order to validate the prognostic effect of the immunophenotypic cluster, another 36 patients with NPM1 mutation diagnosed between 2008 and 2010 were analyzed.

RESULTS:

Ninety-four patients with NPM1 mutations and complete immunophenotyping data were enrolled for a hierarchical cluster analysis and the result was correlated with clinico-laboratory characteristics. Clustering analysis divided the patients with NPM1 mutations into the following two groups group I, CD34(-)/CD7(-), but with variable expression of HLA-DR; and group II, HLA DR(+)/CD34(+)/CD7(+). With a median follow-up of 53 months, the group II patients had a significantly shorter relapse-free survival (RFS, median 3 vs. 23 months, p = 0.006) and overall survival (OS, median 11 vs. 40 months, p = 0.02) than group I patients. Multivariate analysis of variables, including clinico-laboratory data and other gene mutations revealed that the immunophenotypic cluster is an independent prognostic factor (RFS, p = 0.002; OS, p = 0.024). In order to confirm the prognostic effect of the immunophenotypic cluster, another 36 patients with NPM1 mutation diagnosed between 2008 and 2010 were validated. Hierarchical cluster analysis also showed two distinct clusters, group I patient showed significant better RFS (p = 0.021), and OS (p = 0.055). In total, we stratified 130 NPM1-mutant patients, by FLT3-ITD mutation and immunophenotypic cluster into distinct prognostic groups (RFS, p < 0.001 and OS, p = 0.017).

CONCLUSIONS:

Among NPM1-mutated AML, the antigen expression pattern of HLADR(+) CD34(+) CD7(+) is associated with a poor prognosis, independent to the FLT3-ITD mutation.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Proteínas Nucleares / Leucemia Mieloide Aguda Tipo de estudo: Prognostic_studies Limite: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Cancer Assunto da revista: NEOPLASIAS Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Taiwan

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Proteínas Nucleares / Leucemia Mieloide Aguda Tipo de estudo: Prognostic_studies Limite: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Cancer Assunto da revista: NEOPLASIAS Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Taiwan