Circulating endothelial cells and their progenitors in acute myeloid leukemia

Abstract

Abstract. Acute myeloid leukemia (AML) is an aggressive hematological malignancy characterized by the accumulation of immature myeloid progenitor cells in the bone marrow. Studies are required to investigate the prognostic and predictive value of surrogate biomarkers. Given the importance of angiogenesis in oncology in terms of pathogenesis as well as being a target for treatment, circulating endothelial cells (CECs) and endothelial progenitor cells (EPCs) are promising candidates to serve as such markers. The aim of the present study was to quantify CECs and EPCs in patients with AML at initial diagnosis and following induction chemotherapy, and to correlate these findings with the response to treatment in AML patients. The present study included 40 patients with de novo AML and 20 age-and gender-matched healthy controls. CECs and EPCs were evaluated by flow cytometry at initial diagnosis and after induction chemotherapy (3+7 protocol for AML other than M3 and all-trans-retinoic acid plus anthracycline for M3 disease). CECs and EPCs were significantly higher in AML patients at diagnosis and after induction chemotherapy than in controls. After induction chemotherapy, CECs and EPCs were significantly decreased compared with the levels at initial diagnosis. Patients who achieved complete response (n=28) had lower initial CEC and EPC levels compared with patients who did not respond to treatment. These results suggest that CEC levels are higher in AML patients and may correlate with disease status and treatment response. Further investigations are required to better determine the predictive value and implication of these cells in AML management.

Insights into Endothelial Progenitor Cells: Origin, Classification, Potentials, and Prospects

“…Moreover, EPCs (including CECs) are increased in the peripheral blood of patients with various cancers, such as multiple myeloma [228], acute myeloid leukaemia [229, 230], nonsmall cell lung cancer (NSCLC) [231], hepatocellular carcinoma [232, 233], breast cancer [234–236], ovarian cancer [237], chronic lymphocytic leukaemia (CLL) [238], renal cell carcinoma (RCC) [239, 240], and endometrial cancer [241]. CECs have been implicated in tumour progression and aggressiveness [230, 231, 235, 237, 238, 240, 241]. Furthermore, in malignant breast carcinoma, EPCs are resistant to the cytokine TNF- α , which is responsible for inducing apoptosis [242].…”

Circulating hematopoietic stem cells, endothelial progenitor cells and cancer stem cells in hepatocellular carcinoma patients: contribution to diagnosis and prognosis

“…were defined by the phenotype of CD34 þ CD133 þ CD45and quantified as a percentage of the total white blood cells population (%HSCs/WBCs). The EPCs were defined by the phenotype of CD144 þ CD34 þ CD133 þ CD45 -, and quantified as percentage from the HSCs subpopulation (% EPCs/ HSCs) [13,32,33].…”

Liquid biopsy technologies for hematological diseases

“…17,58 A retrospective controlled study involving patients with acute myeloid leukemia (AML) showed a correlation between EPC and CEC counts and treatment response. 59 At the initial diagnosis stage, CEC and EPC levels of AML patients were significantly higher than those of the control group, and these levels then decreased after chemotherapy. Although both cell counts correlated with prognosis, it was suggested that a higher CEC count might better reflect the metabolic status and treatment response of patients with AML malignancies.…”