Leukemia-associated immunophenotypes subdivided in "categories of specificity" improve the sensitivity of minimal residual disease in predicting relapse in acute myeloid leukemia.
Adult
Aged
Antigens, CD7
/ immunology
Bone Marrow
/ immunology
CD2 Antigens
/ immunology
CD4 Antigens
/ immunology
CD56 Antigen
/ immunology
Cell Lineage
/ immunology
Female
Flow Cytometry
/ methods
Healthy Volunteers
Humans
Immunophenotyping
/ methods
Leukemia, Myeloid, Acute
/ complications
Male
Middle Aged
Neoplasm, Residual
/ diagnosis
Recurrence
Sialic Acid Binding Ig-like Lectin 3
/ immunology
acute myeloid leukemia
categories of specificity
flow cytometry
leukemia-associated immunophenotypes (LAIPs)
minimal residual disease
Journal
Cytometry. Part B, Clinical cytometry
ISSN: 1552-4957
Titre abrégé: Cytometry B Clin Cytom
Pays: United States
ID NLM: 101235690
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
21
05
2019
revised:
09
10
2019
accepted:
22
10
2019
pubmed:
8
11
2019
medline:
10
6
2021
entrez:
8
11
2019
Statut:
ppublish
Résumé
The assessment of minimal residual disease (MRD) by flow cytometry (FC) has a prognostic impact in acute myeloid leukemia (AML), despite the low sensitivity in predicting relapse. Nonetheless, the role of leukemic-associated immunophenotypes (LAIPs)-related specificity on the sensitivity of MRD has not been clarified yet. In this respect, we accomplished this study. LAIP-frequencies of bone marrow samples from healthy donors and patients after treatment were quantified and subdivided in "categories of specificity" named as: "strong," "good," and "weak." At the following, the diagnostic performance of MRD was investigated in terms of sensitivity, specificity, predictive values, likelihood ratio (LR). "Strong" LAIPs were identified by CD7, CD2, CD4, and CD56 markers while "weak" LAIPs, independently of coexpressed markers, were mainly observed in CD33+ cells. MRD identified patients with significantly low DFS and OS but showed a low sensitivity in predicting relapse. Interestingly, majority of recurrences was noticed in patients with two LAIPs and lacking of "strong" LAIPs or only with one "good" LAIP. Thus, only patients showing one "strong" or two "good" LAIPs were considered suitable for MRD monitoring and selected to be further investigated. In this subset, positive MRD predicted a poor prognosis. Moreover, a higher sensitivity, negative predictive value (NPV) and LR- were observed after comparison with the previous series. These data highlight the relevant role of LAIP classification in "categories of specificity" in improving the sensitivity of MRD as assessed by FC.
Sections du résumé
BACKGROUND
The assessment of minimal residual disease (MRD) by flow cytometry (FC) has a prognostic impact in acute myeloid leukemia (AML), despite the low sensitivity in predicting relapse. Nonetheless, the role of leukemic-associated immunophenotypes (LAIPs)-related specificity on the sensitivity of MRD has not been clarified yet. In this respect, we accomplished this study.
METHODS
LAIP-frequencies of bone marrow samples from healthy donors and patients after treatment were quantified and subdivided in "categories of specificity" named as: "strong," "good," and "weak." At the following, the diagnostic performance of MRD was investigated in terms of sensitivity, specificity, predictive values, likelihood ratio (LR).
RESULTS
"Strong" LAIPs were identified by CD7, CD2, CD4, and CD56 markers while "weak" LAIPs, independently of coexpressed markers, were mainly observed in CD33+ cells. MRD identified patients with significantly low DFS and OS but showed a low sensitivity in predicting relapse. Interestingly, majority of recurrences was noticed in patients with two LAIPs and lacking of "strong" LAIPs or only with one "good" LAIP. Thus, only patients showing one "strong" or two "good" LAIPs were considered suitable for MRD monitoring and selected to be further investigated. In this subset, positive MRD predicted a poor prognosis. Moreover, a higher sensitivity, negative predictive value (NPV) and LR- were observed after comparison with the previous series.
CONCLUSIONS
These data highlight the relevant role of LAIP classification in "categories of specificity" in improving the sensitivity of MRD as assessed by FC.
Identifiants
pubmed: 31697027
doi: 10.1002/cyto.b.21855
doi:
Substances chimiques
Antigens, CD7
0
CD2 Antigens
0
CD4 Antigens
0
CD56 Antigen
0
Sialic Acid Binding Ig-like Lectin 3
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
216-225Informations de copyright
© 2019 International Clinical Cytometry Society.
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