TY - JOUR
T1 - Clinical significance of CD56 expression in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline-based regimens
AU - Montesinos, P
AU - Rayon, C
AU - Vellenga, E
AU - Brunet, S
AU - Gonzalez, J
AU - Gonzalez, M
AU - Holowiecka, A
AU - Esteve, J
AU - Bergua, J
AU - Gonzalez, JD
AU - Rivas, C
AU - Tormo, M
AU - Rubio, V
AU - Bueno, J
AU - Manso, F
AU - Milone, G
AU - de la Serna, J
AU - Perez, I
AU - Perez-Encinas, M
AU - Krsnik, I
AU - Ribera, JM
AU - Escoda, L
AU - Löwenberg, Bob
AU - Sanz, MA
PY - 2011
Y1 - 2011
N2 - The expression of CD56 antigen in acute promyelocytic leukemia (APL) blasts has been associated with short remission duration and extramedullary relapse. We investigated the clinical significance of CD56 expression in a large series of patients with APL treated with all-trans retinoic acid and anthracycline-based regimens. Between 1996 and 2009, 651 APL patients with available data on CD56 expression were included in 3 subsequent trials (PETHEMA LPA96 and LPA99 and PETHEMA/HOVON LPA2005). Seventy-two patients (11%) were CD56(+) ( expression of CD56 in >= 20% leukemic promyelocytes). CD56(+) APL was significantly associated with high white blood cell counts; low albumin levels; BCR3 isoform; and the coexpression of CD2, CD34, CD7, HLA-DR, CD15, and CD117 antigens. For CD56(+) APL, the 5-year relapse rate was 22%, compared with a 10% relapse rate for CD56(+) APL (P = .006). In the multivariate analysis, CD56 expression retained the statistical significance together with the relapse-risk score. CD56(+) APLalso showed a greater risk of extramedullary relapse (P < .001). In summary, CD56 expression is associated with the coexpression of immaturity-associated and T-cell antigens and is an independent adverse prognostic factor for relapse in patients with APL treated with all-trans-retinoic acid plus idarubicin-derived regimens. This marker may be considered for implementing risk-adapted therapeutic strategies in APL. The LPA2005 trial is registered at http://www.clinicaltrials.govasNCT00408278. (Blood. 2011;117(6):1799-1805)
AB - The expression of CD56 antigen in acute promyelocytic leukemia (APL) blasts has been associated with short remission duration and extramedullary relapse. We investigated the clinical significance of CD56 expression in a large series of patients with APL treated with all-trans retinoic acid and anthracycline-based regimens. Between 1996 and 2009, 651 APL patients with available data on CD56 expression were included in 3 subsequent trials (PETHEMA LPA96 and LPA99 and PETHEMA/HOVON LPA2005). Seventy-two patients (11%) were CD56(+) ( expression of CD56 in >= 20% leukemic promyelocytes). CD56(+) APL was significantly associated with high white blood cell counts; low albumin levels; BCR3 isoform; and the coexpression of CD2, CD34, CD7, HLA-DR, CD15, and CD117 antigens. For CD56(+) APL, the 5-year relapse rate was 22%, compared with a 10% relapse rate for CD56(+) APL (P = .006). In the multivariate analysis, CD56 expression retained the statistical significance together with the relapse-risk score. CD56(+) APLalso showed a greater risk of extramedullary relapse (P < .001). In summary, CD56 expression is associated with the coexpression of immaturity-associated and T-cell antigens and is an independent adverse prognostic factor for relapse in patients with APL treated with all-trans-retinoic acid plus idarubicin-derived regimens. This marker may be considered for implementing risk-adapted therapeutic strategies in APL. The LPA2005 trial is registered at http://www.clinicaltrials.govasNCT00408278. (Blood. 2011;117(6):1799-1805)
U2 - 10.1182/blood-2010-04-277434
DO - 10.1182/blood-2010-04-277434
M3 - Article
C2 - 21148082
SN - 0006-4971
VL - 117
SP - 1799
EP - 1805
JO - Blood
JF - Blood
IS - 6
ER -