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- Title
Presence of CD34<sup>+</sup>CD38<sup>−</sup>CD58<sup>−</sup> leukemia-propagating cells at diagnosis identifies patients at high risk of relapse with Ph chromosome-positive ALL after allo-hematopoietic SCT.
- Authors
Kong, Y; Xu, L-P; Liu, Y-R; Qin, Y-Z; Sun, Y-Q; Wang, Y; Jiang, H; Jiang, Q; Chen, H; Chang, Y-J; Huang, X-J
- Abstract
Relapse of Ph chromosome-positive ALL (Ph+ALL) results from the persistence of leukemia-propagating cells (LPCs). In Ph+ALL, a xenograft assay recently determined that LPCs are enriched in the CD34+CD38−CD58− fraction. Therefore, the prognostic significance of LPCs in Ph+ALL subjects after allogeneic hematopoietic SCT (allo-HSCT) was investigated. A total of 80 consecutive adults with Ph+ALL who underwent allo-HSCT were eligible. A multi-parameter flow cytometry analysis examining CD58-FITC/CD10-PE/ CD19-APC-Cy7/CD34-PerCP/CD45-Vioblue/ CD38-APC on gated leukemia BM blasts was performed at diagnosis. Based on the original blast phenotypes, subjects were stratified into the CD34+CD38−CD58−group (N=15) and other phenotype group (N=65). During minimal residual disease monitoring, significantly higher levels of BCR/ABL transcripts were detected in subjects in the CD34+CD38−CD58− group than in other phenotype group, especially at 3 months post HSCT. In addition, CD34+CD38−CD58−LPCs are directly correlated with a higher 3-year cumulative incidence of relapse (CIR) and worse leukemia-free survival (LFS) and OS. Multivariate analyses indicated that presence of CD34+CD38−CD58− LPCs at diagnosis, and BCR-ABL reduction at 3 months post HSCT were independent risk factors for relapse, LFS and OS. Our data suggest that presence of CD34+CD38−CD58− LPCs at diagnosis allows rapid identification of high-risk patients for relapse after allo-HSCT.
- Subjects
PROGNOSTIC tests; LYMPHOCYTIC leukemia; LYMPHOBLASTIC leukemia treatment; HEMATOPOIETIC stem cell transplantation; TRANSPLANTATION of organs, tissues, etc.
- Publication
Bone Marrow Transplantation, 2015, Vol 50, Issue 3, p348
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/bmt.2014.274