Natural killer cells mediate antibody-dependent cell-mediated cytotoxicity, and CD16 exerts key functions to induce antibody-dependent cell-mediated cytotoxicity response. Because the prognostic relevance of aberrant CD16 expression in AML patients at diagnosis is unknown, we analyzed 325 AML patients undergoing intensive chemotherapy for aberrant CD16+ and CD56+ natural killer-cell marker expression. CD56+ AML patients had inferior median event-free (EFS; P = 0.0699) and overall survival (OS; 10.9 versus 20.6 months; P = 0.0132). Patients expressing CD16 had worse median EFS (P = 0.0622) and OS (13.0 versus 45.9 months; P = 0.0277). EFS for CD16+/CD56+ patients was 5.7 months compared with 7.1 months for CD16-/CD56- (P = 0.3690), and OS was 10.6 months for CD16+/CD56+ patients compared with 52.2 months for CD16-/CD56- patients (P = 0.0311). Patients with CD16+/CD56+ expression had a lower probability to achieve complete remission after 2 induction cycles (52% versus 72%). Our data suggest that AML patients with aberrant CD16 and CD56 expression have adverse survival outcomes.

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