CD34-Negative is Highly Associated with T (15;17), T (V; 11q23) and the NPM1-Mutation Subtypes in 343 Newly Diagnosed Patients with Acute Myeloid Leukemia

Abstract

Objective: Recent reports found that several cytogenetic or molecular subtypes of acute myeloid leukemia (AML) are associated with CD34-positive. However, the status of CD34-negative in AML needs to be explored. In this study, we aimed to explore the prevalence of the CD34-negative patients and its association with molecular genetics status in a large consecutive AML cohort. Methods:A group of 343 consecutive newly diagnosed AML patients was retrospectively analyzed in our center. CD34 expression was detected by flow cytometry and considered negative when it was expressed in less than 20% of the bone marrow blast cells. The karyotype was analyzed by the G-banding technique. Leukemic fusion genes and mutated genes were detected by PCR method.Results: CD34-negative was found in 143 (41.7%) of the 343 patients. According to FAB classification, the percentages of CD34-negative patients were higher in the M3 and M5 (100% and 70%, respectively) and lower in the M2 and M4 subtypes (30.3% and 21.2%, respectively). According to the WHO classification, the percentage of CD34-negative patients was higher in those with t(15; 17), t(v; 11q23), and the NPM1-mutation (100%, n=37; 100%, n=7; and 81.7%, n=71, respectively) and lower in those with t(8;21) and AML with MDS-related changes (8.6%, n=35 and 5.0%, n=20, respectively). The patients with t(15; 17), t(v; 11q23) and the NPM1-mutation consisted of 71.3% (102/143) of the CD34-negative population and 6.5% (13/200) of the CD34-positive population (p<0.0001). A CD34-negative phenotype was associated with risk subgroups according to cytogenetics alone and when combining cytogenetics and molecular analysis (p=0.025 and p<0.0001, respectively). The sensitivity, specificity, positivepredictive value and negative-predictive value of the CD34-negative to t (15;17), t (v; 11q23) and the NPM1-mutation were 88.7%, 82.0%, 71.3% and 93.5%, respectively. Conclusions:The prevalence of the CD34-negative patients is very common in newly diagnosed AML. CD34-negative is highly associated with t (15;17), t(v; 11q23) and the NPM1-mutation in AML patients, which provide the evidence about the association of immunophenotype and molecular genetics.

CD34 negative HLA‐DR negative acute myeloid leukaemia: A higher association with NPM1 and FLT3‐ITD mutations

“…17 and M5 subtypes and lower in the M0, M2 and M4 subtypes. 19 HLA-DR negativity is known to be useful for distinguishing APL from other subtypes of AML. But, among all AML patients, apart from 8% to 17% of APL cases, HLA-DR negativity without the PML-RARA fusion gene have also been described in 1.2%-24% of cases.…”

“…AML patients were mostly HLA‐DR and CD34 positive and the frequency of HLA‐DR and CD34 expression is different in different AML subtypes. The percentage of CD34‐negative patients is higher in the M3 and M5 subtypes and lower in the M0, M2 and M4 subtypes 19 . HLA‐DR negativity is known to be useful for distinguishing APL from other subtypes of AML.…”