Expression of CD56 is an unfavorable prognostic factor for acute promyelocytic leukemia with higher initial white blood cell counts
Adult
Male
0301 basic medicine
Adolescent
Disease-Free Survival
Leukocyte Count
03 medical and health sciences
0302 clinical medicine
Leukemia, Promyelocytic, Acute
Antineoplastic Combined Chemotherapy Protocols
Humans
Prospective Studies
Aged
2. Zero hunger
Platelet Count
Remission Induction
Cytarabine
Original Articles
Middle Aged
Prognosis
CD56 Antigen
3. Good health
Treatment Outcome
Female
Neoplasm Recurrence, Local
Idarubicin
DOI:
10.1111/cas.12319
Publication Date:
2013-11-11T03:32:47Z
AUTHORS (19)
ABSTRACT
Expression of CD56 has recently been introduced as one of the adverse prognostic factors in acute promyelocytic leukemia (APL). However, the clinical significance of CD56 antigen in APL has not been well elucidated. We assessed the clinical significance of CD56 antigen in 239 APL patients prospectively treated with all‐trans retinoic acid and chemotherapy according to the Japan Adult Leukemia Study Group APL97 protocol. All patients were prospectively treated by the Japan Adult Leukemia Study Group APL97 protocol. The median follow‐up period was 8.5 years. Positive CD56 expression was found in 23 APL patients (9.6%). Expression of CD56 was significantly associated with lower platelet count (P = 0.04), severe disseminated intravascular coagulation (P = 0.04), and coexpression of CD2 (P = 0.03), CD7 (P = 0.04), CD34 (P < 0.01) and/or human leukocyte antigen‐DR (P < 0.01). Complete remission rate and overall survival were not different between the two groups. However, cumulative incidence of relapse and event‐free survival (EFS) showed an inferior trend in CD56+ APL (P = 0.08 and P = 0.08, respectively). Among patients with initial white blood cell counts of 3.0 × 109/L or more, EFS and cumulative incidence of relapse in CD56+ APL were significantly worse (30.8% vs 63.6%, P = 0.008, and 53.8% vs 28.9%, P = 0.03, respectively), and in multivariate analysis, CD56 expression was an unfavorable prognostic factor for EFS (P = 0.04). In conclusion, for APL with higher initial white blood cell counts, CD56 expression should be regarded as an unfavorable prognostic factor.
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