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- Title
A distinctive nuclear morphology in acute myeloid leukemia is strongly associated with loss of HLA-DR expression and FLT3 internal tandem duplication.
- Authors
Kussick, S. J.; Stirewalt, D. L.; Yi, H. S.; Sheets, K. M.; Pogosova-Agadjanyan, E.; Braswell, S.; Norwood, T. H.; Radich, J. P.; Wood, B. L.
- Abstract
In a 5-year survey of nonpromyelocytic/nonmonocytic acute myeloid leukemias (AMLs) diagnosed in the University of Washington Hematopathology Laboratory, we identified 19 cases containing distinctive, cup-like nuclear indentation in 10% or more of the blasts ('AML-cuplike'). Fourteen of these cases (74%) demonstrated near-complete loss of HLA-DR expression, while the other five cases showed partial loss of HLA-DR. A total of 16 of the cases (84%) demonstrated internal tandem duplication (ITD) of the Flt3 gene. When compared to a selected set of AMLs lacking this nuclear morphology, AML-cuplike was significantly more likely to lack HLA-DR and CD34 expression, to express CD123 without CD133, to have a normal karyotype, and to harbor the Flt3 ITD. To characterize AML-cuplike in an unselected series of AMLs, we analyzed 42 consecutive nonpromyelocytic/nonmonocytic AMLs diagnosed in our laboratory during a 6-month period in 2002. Strikingly, in this unselected series, there was a statistically significant coincidence of invaginated nuclear morphology, loss of HLA-DR, and presence of the Flt3 ITD beyond that expected if these three features were unrelated, suggesting that AMLs with these three features may represent a distinct AML subset.
- Subjects
ACUTE myeloid leukemia; MYELOID leukemia; HLA histocompatibility antigens; LEUKEMIA etiology; GENETICS; MORPHOLOGY; PROTEIN metabolism; HLA-B27 antigen; GENETIC mutation; HEMATOPOIETIC growth factors; RETROSPECTIVE studies; KARYOTYPES; CELL nuclei; TRANSFERASES; GENOMES; RESEARCH funding; ACUTE diseases
- Publication
Leukemia (08876924), 2004, Vol 18, Issue 10, p1591
- ISSN
0887-6924
- Publication type
journal article
- DOI
10.1038/sj.leu.2403458