Clinical significance of CD56 expression in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline-based regimens
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- Pau Montesinos
- Hospital Universitario La Fe, Valencia, Spain;
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- Chelo Rayón
- Hospital Central de Asturias, Oviedo, Spain;
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- Edo Vellenga
- University Hospital, Groningen, The Netherlands;
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- Salut Brunet
- Hospital Sant Pau, Barcelona, Spain;
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- José González
- Hospital Universitario Virgen del Rocío, Sevilla, Spain;
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- Marcos González
- Hospital Universitario, Salamanca, Spain;
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- Aleksandra Holowiecka
- M. Sklodowska-Curie Memorial Institute, Gliwice, Poland;
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- Jordi Esteve
- Hospital Clinic, Barcelona, Spain;
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- Juan Bergua
- Hospital San Pedro de Alcántara, Cáceres, Spain;
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- José D. González
- Hospital Insular, Las Palmas, Spain;
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- Concha Rivas
- Hospital General, Alicante, Spain;
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- Mar Tormo
- Hospital Clínico Universitario, Valencia, Spain;
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- Vicente Rubio
- Hospital General, Jerez de la Frontera, Spain;
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- Javier Bueno
- Hospital Universitario Valle d′Hebron, Barcelona, Spain;
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- Félix Manso
- Hospital General, Albacete, Spain;
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- Gustavo Milone
- Fundaleu, Buenos Aires, Argentina;
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- Javier de la Serna
- Hospital 12 de Octubre, Madrid, Spain;
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- Inmaculada Pérez
- Hospital Universitario Virgen de la Victoria, Málaga, Spain;
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- Manuel Pérez-Encinas
- Hospital Clínico Universitario, Santiago de Compostela, Spain;
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- Isabel Krsnik
- Hospital Puerta de Hierro, Madrid, Spain;
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- Josep M. Ribera
- Hospital Universitari Germans Trias i Pujol, Barcelona, Spain;
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- Lourdes Escoda
- Hospital Joan XXIII, Tarragona, Spain; and
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- Bob Lowenberg
- Erasmus University Medical Center, Rotterdam, The Netherlands
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- Miguel A. Sanz
- Hospital Universitario La Fe, Valencia, Spain;
抄録
<jats:title>Abstract</jats:title> <jats:p>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+ APL also 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.gov as NCT00408278.</jats:p>
収録刊行物
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- Blood
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Blood 117 (6), 1799-1805, 2011-02-10
American Society of Hematology