Prognostic Significance of CD7+CD56+ Phenotype and Chromosome 5 Abnormalities for Acute Myeloid Leukemia M0

Suzuki, Ritsuro; Murata, Makoto; Kami, Masahiro; Ohtake, Shigeki; Asou, Norio; Kodera, Yoshihisa; Tomonaga, Masao; Yasukawa, Masaki; Kusumoto, S; Jin, Tao; Matsuda, Shin; Hirai, Hisamaru; Yorimitsu, Masanori; Hamajima, Nobuyuki; Seto, Masao; Shimoyama, Masanori; Ohno, Ryuzo; Morishima, Yasuo; Nakamura, Shigeo

doi:10.1007/bf02986617

Cited by 31 publications

(20 citation statements)

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“…11 The expression of CD56 has been shown to be of prognostic relevance in certain hematologic malignancies. [5][6][7]29 In the small series of Montero et al, an inferior survival of CD56 + T-ALL was reported. 8 Therefore, we analyzed the impact of CD56 expression on outcome in our series.…”

Section: Discussionmentioning

confidence: 99%

CD56 expression in T-cell acute lymphoblastic leukemia is associated with non-thymic phenotype and resistance to induction therapy but no inferior survival after risk-adapted therapy

Fischer

Gökbuget²,

Schwartz³

et al. 2008

Haematologica

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BackgroundExpression of CD56 has been associated with poor prognosis in acute myeloid leukemia and aggressive lymphoma. Design and MethodsWe analyzed the impact of CD56 expression in a cohort of 452 newly diagnosed adult Tcell acute lymphoblastic leukemia (T-ALL) patients; clinical data were available for 306 patients. Treatment was according to the GMALL study protocols 06/99 and 07/03 stipulating stratification into standard (thymic T-ALL) and high risk (pre-and mature T-ALL) groups. ResultsCD56 expression was detected in 63/452 (13.9%) patients. CD56+ T-ALL were predominantly of non-thymic (pre-T 35%, mature 41%) immunophenotypic subtypes, whereas 53% of the CD56 -cases were thymic T-ALL (p=0.00002). CD13, CD33, CD34 and HLA-DR were significantly more frequently expressed. A clonal T-cell receptor rearrangement was detected in 22/23 CD56 + ALL. No major clinical differences were observed at presentation. Treatment of CD56 + ALL resulted in a lower rate of complete remissions (70% vs. 88%) (p=0.001) and a higher rate of resistant disease (21% vs. 8%) (p=0.004). CD56 expression had no significant influence on overall (48% vs. 59%) and disease free survival (67% vs. 57%) at three years. ConclusionsCD56 is expressed on a subset of adult T-ALL with distinct immunophenotypical features and higher resistance to therapy. Most CD56 + ALL were treated in the high-risk arm of the GMALL study protocols owing to their non-thymic phenotype. Thus after risk adapted treatment a prognostic impact of CD56 expression was not detectable.Key words: T-cell ALL, CD56, natural killer, immunophenotype. Haematologica 2009; 94:224-229. doi: 10.3324/haematol.13543 ©2009 Ferrata Storti Foundation. This is an open-access paper. Citation: Fischer L, Gökbuget N, Schwartz S, Burmeister T, Rieder H, Brüggemann M, Hoelzer D, and Thiel E. CD56 expression in T-cell acute lymphoblastic leukemia is associated with non-thymic phenotype and resistance to induction therapy but no inferior survival after risk-adapted therapy. CD56 expression in T-cell acute lymphoblastic leukemia is associated with non-thymic phenotype and resistance to induction therapy but no inferior survival after risk-adapted therapy

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Section: Discussionmentioning

confidence: 99%

CD56 expression in T-cell acute lymphoblastic leukemia is associated with non-thymic phenotype and resistance to induction therapy but no inferior survival after risk-adapted therapy

Fischer

Gökbuget²,

Schwartz³

et al. 2008

Haematologica

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“…Myeloid antigen-positive T/NK bi-potential progenitors are believed to develop by transformation into myeloid/NK cell precursor acute leukaemia [15,16]. NK-cell lineage committed progenitors are also hypothesized to transform to blastic NK-cell lymphoma (BNKL) or precursor NKcell acute lymphoblastic leukaemia/lymphoma (NK-ALL) [17,18].…”

Section: Pathological Transformation Of Nk-cellsmentioning

confidence: 99%

Extranodal NK/T‐cell lymphoma: diagnosis and treatment cues

Suzuki

Takeuchi

Ohshima

et al. 2008

Hematological Oncology

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134

130

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Extranodal NK/T-cell lymphoma, nasal type (ENKL) is mostly endemic to East Asia. It predominantly occurs in the nasal or paranasal areas and less frequently in the skin. Most of the tumours show NK-cell, but rarely T-cell, phenotypes. The Epstein-Barr virus (EBV) genome can be usually detected in lymphoma cells. Geographic localization of ENKL matches the endemic distribution of EBV, suggesting that EBV plays an important role in lymphomagenesis. Originally, NK-cell and T-cell types were believed to present the same clinicopathologic characteristics, but recent data suggest more aggressive characteristics for the NK-cell phenotype. Although ENKL is sensitive to radiotherapy, it shows a poorer response to chemotherapeutic agents than other lymphomas due to expression of p-glycoprotein. Therefore, new therapeutic approaches must be considered. Several new clinical trials are now being conducted in East Asia.

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“…These cases were classified as AML M0 according to the FAB classification 129,130 , and were distinct from CD56-positive tumors of myeloid/NK cell acute leukemia with mature promyelocytoid morphology 131 , as well as BNKL 99 . However, this form of leukemia was later found to exhibit different clinical characteristics from CD7 − or CD56 − AML M0 132 , and was thus a distinct disease entity among AML subclasses.…”

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Leukemia and Lymphoma of Natural Killer Cells

Suzuki

2005

J Clin Exp Hematopathol

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Malignant hematolymphoid disorders arising from NK cells have become widely recognized over the past decade. The two forms of NK-cell malignancy, aggressive NK-cell leukemia (ANKL) and extranodal NK-cell lymphoma of nasal type (ENKL) are both characterized by the proliferation of tumor cells with an NK-cell like immunophenotype. ANKL usually presents with bone marrow tumor cells accompanied by circulating leukemic cells, and hepatosplenomegalay is a common clinical feature. ENKL most frequently affects the nasal or paranasal regions, with cutaneous involvement also being common. Approximately 70 percent of ENKL present with localized tumor cells, and follow an indolent clinical course, but, in advanced cases, tumors rapidly expand and are frequently fatal. Tumor cells from both ANKL and ENKL are surface CD3 − and CD56 + but differ in their expression of CD16. Epstein-Barr virus (EBV) is found in most cases of NK-cell leukemia/lymphoma, suggesting an oncogenic role, but patients may have biclonal or polyclonal populations of malignant cells based on differential EBV genome incorporation. NK-cell neoplasms are frequently resistant to chemotherapy due to p-glycoprotein expression and associated multidrug resistance. The prognoses of both localized and advanced stages of NK-cell malignancies are worse than most other lymphoid malignancies, but studies are currently underway to assess the safety and efficacy of novel chemoradiotherapy regimens for the treatment of these neoplasms.

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Prognostic Significance of CD7+CD56+ Phenotype and Chromosome 5 Abnormalities for Acute Myeloid Leukemia M0

Cited by 31 publications

References 50 publications

CD56 expression in T-cell acute lymphoblastic leukemia is associated with non-thymic phenotype and resistance to induction therapy but no inferior survival after risk-adapted therapy

CD56 expression in T-cell acute lymphoblastic leukemia is associated with non-thymic phenotype and resistance to induction therapy but no inferior survival after risk-adapted therapy

Extranodal NK/T‐cell lymphoma: diagnosis and treatment cues

Leukemia and Lymphoma of Natural Killer Cells

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