급성백혈병에서 CD34 세포면역표지자의 임상적 의의

Abstract

Background : It has been shown by some investigators that the expression of CD34 antigen by leukemic cells of patients with acute myelogenous leukemia was found to be significantly associated with adverse prognosis. But the others could not confirm the previous reports on the prognostic value of CD34. Discussing CD34 expression in acute leukemia within the context of the recent debate on its possible prognostic ret-evance, we present our own data on its biological and clinical implications in patients with de novo acute leukemia. Material and Method : We have analyzed the correlation of CD34 expression with the clinicopathological parameters and therapeutic outcomes to the various chromo-therapy in 87 patients with acute leukemia retrospectively. Expression of CD34 anti-gen on the leukemic blasts was analysed by flow cytometry indirect immunoflu-orescence method. The leukemic population was considered CD34 positive if at least 10% of bone marrow blast cells reacted with the monoclonal antibody anti-HPCA-1. Results : In our series, CD34 was positive in 65.5% of cases with acute leukemia. We could not detect any significant differences with respect to sex, age, hemograms including white blood cell count, and FAB subtype distribution between CD34-posi- tive(CD34+) and CD34-negative(CD34-) cases, although CD34 expression was signif-icantly rare in acute promyelocytic leukemia. CD34 expression had substantial effect on the remission rate: 72.4% in CD34+ versus 92.0% in CD34- acute leukemia. But survival analysis after a median follow-up of 232 days revealed no significant influence of CD34 expression on overall survival. Conclusion: Our results could support the concept of CD34 as a predictor of resistance to remission induction chemotherapy, although the prognostic relevance of CD34 expression is not justified at this time.