Original Article

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Blood Res 2014; 49(4):

Published online December 31, 2014

https://doi.org/10.5045/br.2014.49.4.241

© The Korean Society of Hematology

Aberrant myeloid antigen co-expression is correlated with high percentages of CD34-positive cells among blasts of acute lymphoblastic leukemia patients: an Indian tertiary care center perspective

Rahul Kumar Sharma, Abhishek Purohit, Venkatesan Somasundaram, Pravas Chandra Mishra, Mrinalini Kotru, Ravi Ranjan, Sunil Kumar, Sudha Sazawal, Hara Prasad Pati, Seema Tyagi, and Renu Saxena*

Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.

Correspondence to : Correspondence to Renu Saxena, M.D. Department of Hematology, AIIMS, New Delhi 110029, India. Tel: +91-11-2659-4670, Fax: +91-11-2658-8663, renusaxena@outlook.com

Received: July 29, 2014; Revised: October 7, 2014; Accepted: November 14, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Aberrant myeloid antigen (MA) co-expression and high expression of CD34 antigen on the blasts of acute lymphoblastic leukemia (ALL) patients are independently reported to have a role in pathogenesis and prognosis. This study was conducted to determine whether these two parameters are related.

Methods

A total of 204 cases of ALL were included in an analysis of blast immunophenotypic data. CD34 expression was categorized as low when less than 50% of blasts were CD34-positive (CD34low) and as high when 50% or more were CD34-positive (CD34high).

Results

Of 204 cases of ALL, 163 and 41 were of B-cell origin (B-ALL) and T-cell origin (T-ALL), respectively. Of all cases, 132 (64.7%) showed co-expression of MA and among these, 101 (76.51%) were CD34high, while the remaining 31 (23.48%) were CD34low. Of 72 cases without MA co-expression, 25 (34.72%) were CD34high and 47 (67.25%) were CD34low. Furthermore, of 163 cases of B-ALL, 111 showed co-expression of MA and 84 of these were CD34high. Of 52 cases of B-ALL without MA expression, 22 were CD34high. Among 41 cases of T-ALL, 21 co-expressed MA, 17 of which were CD34high. Moreover, all 20 cases of T-ALL without co-expression of MA were CD34low. These differences were statistically significant.

Conclusion

We observed a strong correlation between aberrant MA expression and CD34high expression on the blasts of ALL. We hypothesize that these different patient subsets may represent unique prognostic characteristics.

Keywords CD34, Acute lymphoblastic leukemia, Immunophenotyping, Aberrant myeloid antigen co-expression, Flow cytometry

Article

Original Article

Blood Res 2014; 49(4): 241-245

Published online December 31, 2014 https://doi.org/10.5045/br.2014.49.4.241

Copyright © The Korean Society of Hematology.

Aberrant myeloid antigen co-expression is correlated with high percentages of CD34-positive cells among blasts of acute lymphoblastic leukemia patients: an Indian tertiary care center perspective

Rahul Kumar Sharma, Abhishek Purohit, Venkatesan Somasundaram, Pravas Chandra Mishra, Mrinalini Kotru, Ravi Ranjan, Sunil Kumar, Sudha Sazawal, Hara Prasad Pati, Seema Tyagi, and Renu Saxena*

Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.

Correspondence to: Correspondence to Renu Saxena, M.D. Department of Hematology, AIIMS, New Delhi 110029, India. Tel: +91-11-2659-4670, Fax: +91-11-2658-8663, renusaxena@outlook.com

Received: July 29, 2014; Revised: October 7, 2014; Accepted: November 14, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Aberrant myeloid antigen (MA) co-expression and high expression of CD34 antigen on the blasts of acute lymphoblastic leukemia (ALL) patients are independently reported to have a role in pathogenesis and prognosis. This study was conducted to determine whether these two parameters are related.

Methods

A total of 204 cases of ALL were included in an analysis of blast immunophenotypic data. CD34 expression was categorized as low when less than 50% of blasts were CD34-positive (CD34low) and as high when 50% or more were CD34-positive (CD34high).

Results

Of 204 cases of ALL, 163 and 41 were of B-cell origin (B-ALL) and T-cell origin (T-ALL), respectively. Of all cases, 132 (64.7%) showed co-expression of MA and among these, 101 (76.51%) were CD34high, while the remaining 31 (23.48%) were CD34low. Of 72 cases without MA co-expression, 25 (34.72%) were CD34high and 47 (67.25%) were CD34low. Furthermore, of 163 cases of B-ALL, 111 showed co-expression of MA and 84 of these were CD34high. Of 52 cases of B-ALL without MA expression, 22 were CD34high. Among 41 cases of T-ALL, 21 co-expressed MA, 17 of which were CD34high. Moreover, all 20 cases of T-ALL without co-expression of MA were CD34low. These differences were statistically significant.

Conclusion

We observed a strong correlation between aberrant MA expression and CD34high expression on the blasts of ALL. We hypothesize that these different patient subsets may represent unique prognostic characteristics.

Keywords: CD34, Acute lymphoblastic leukemia, Immunophenotyping, Aberrant myeloid antigen co-expression, Flow cytometry

Fig 1.

Figure 1.

Flow cytometric dot plots representing variable CD34 positivity in blasts of acute lymphoblastic leukemia. Dot plot (A) is representative of CD34low and dot plot (B) is representative of CD34high.

Blood Research 2014; 49: 241-245https://doi.org/10.5045/br.2014.49.4.241

Fig 2.

Figure 2.

Frequencies of different patient subsets with respect to their association of myeloid antigen co-expression and CD34 percentage.

Blood Research 2014; 49: 241-245https://doi.org/10.5045/br.2014.49.4.241

Table 1 . Demographic details of the different subsets of the patients analyzed..

Abbreviations: Hb, hemoglobin; TLC, total leukocyte count; Plt, platelet..


Table 2 . Aberrant myeloid antigen co-expression and its correlation with blast CD34 percentage..

Abbreviations: ALL, acute lymphoblastic leukemia; T-ALL, T cell acute lymphoblastic leukemia; B-ALL, B cell acute lymphoblastic leukemia..


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