PROGNOSTIC SIGNIFICANCE OF CD56 EXPRESSION IN ACUTE LEUKEMIAS

  • B. M. Ahmed
  • N. A. Kantoush
  • M. A. Ismail Mona Ain Shams University
  • D. A. Abd-El Haleem

Abstract

Background. CD56 expression was extensively investigated in cases of acute leukemia. Many studies associated it with short overall survival, unfavorable outcome, lower rates or short complete remission, however the results remain controversial.
Objectives. The aim of this study was to investigate the frequency and prognostic relevance of CD56 expression in patients with acute leukemia and to compare its value with other standard prognostic factors, such as age, gender, leukocytosis, morphologic subtypes, extramedullary invasion, cytogenetic abnormalities and performance status.
Methods. Forty cases of acute leukemia treated at Ain Shmas University hospitals were investigated. They were classified by the French-American-British group (FAB) criteria, flow cytometry, and cytogenetics data. They included twenty cases of acute myeloid leukemia (AML) and twenty cases of acute lymphoblastic leukemia (ALL).
Results. CD56 positive expression was detected in nine cases of AML (45 %), and only in two patients with ALL (10 %). The highest incidence of CD56 positivity was in FAB subtypes M1 (35 %) and M2 (35 %).Association studies between CD56 expression and other prognostic factors in AML cases showed no significant association with age, gender, clinical presentation, hematological data or cytogenetic risk groups. Incidence of relapse was higher in AML patients expressing CD56 than those who did not (66.7 % vs 10 %, P=0.01). Higher death rates were encountered in AML cases with CD56 expression than those without (55.6 % vs 10 %, P=0.032).
Conclusions. CD56 antigenic expression in AML cases represents an adverse prognostic factor. It should be regularly investigated in cases of AML for better prognostic stratification and assessment.


KEY WORDS: CD56; leukemia, myeloid; prognosis

Author Biography

M. A. Ismail, Mona Ain Shams University
Professor of Clinical Pathology, Ain Shams University

References

Alegretti AP, Bittar CM, Bittencourt R, Piccoli AK, SchneiderL, Silla LM, BoSD, Xavier RM. The expression of CD56 antigen is associated with poor prognosis in patients with acute myeloid leukemia. Revistabrasileira de hematologia e hemoterapia 2011; 33: 202-206.

Syrjala M, Anttila VJ, Ruutu T, Jansson SE. Flow cytometric detection of residual disease in acute leukemia by assaying blasts co-expressing myeloid and lymphatic antigens. Leukemia 1994; 8: 1564-1570.

Schabath R, Ratei R, Ludwig WD. The prognostic significance of antigen expression in leukaemia. Best Pract Res ClinHaematol 2003; 16(4): 613-628.

Lanier LL, Le AM, Civin CI, et al. The relationship of CD16 (Leu-11) and Leu-19 (NKH-1) antigen expression on human peripheral blood NK cells and cytotoxic T lymphocytes. J Immunol 1986; 136: 4480-4486.

Chang H, Brandwein J, Yi QL, Chun K, Patterson B, Brien B.Extramedullary infiltrates of AML are associated with CD56 expression, 11q23 abnormalities and inferior clinical outcome. Leuk Res 2004; 28(10): 1007-1011.

Ravandi F, Cortes J, Estrov Z, Thomas D, Giles FJ, Huh YO, et al. CD56 expression predicts occurrence of CNS disease in acute lymphoblastic leukemia. Leuk Res 2002; 26(7): 643-649.

Suzuki R, Kagami Y, Takeuchi K, Kami M, Okamoto M, Ichinohasama R, et al. Prognostic significance of CD56 expression for ALK-positive and ALK-negative anaplastic large-cell lymphoma of T/null cell phenotype. Blood 2000; 96(9): 2993-3000.

Cook G, Dumbar M, Franklin IM. The role of adhesion molecules in multiple myeloma. Acta Haematol 1997; 97(1-2): 81-9.

Tiftik N, Bolaman Z, Batun S,Ayyildiz O, Isikdogan A, Kadikoylu G, Muftuoglu E. The importance of CD7 and CD56 antigens in acute leukaemias 2004; 58(2): 149-152.

Murray CK, Estey E, Paietta E, Howard RS, Edenfield WJ, Pierce S, et al. CD56 expression in acute promyelocytic leukemia: a possible indicator of poor treatment outcome? J Clin Oncol 1999; 17(1): 293-297.

Raspadori D, Damiani D, Lenoci M, Rondelli D, Testoni N, Nardi G, et al. CD56 antigenic expression in acute myeloid leukemia identifies patients with poor clinical prognosis. Leukemia 2001; 15(8): 1161-1164.

Ferrara F, Morabito F, Martino B, Specchia G, Liso V, Nobile F, et al. CD56 expression is an indicator of poor clinical outcome in patients with acute promyelocytic leukemia treated withsimultaneous all-trans-retinoic acid and chemotherapy. J Clin Oncol 2000; 18(6): 1295-1300.

Chang H, Salma F, Yi QL, Patterson B, Brien B, Minden MD. Prognostic relevance of immunophenotyping in 379 patients with acute myeloid leukemia. Leuk Res 2004; 28(1): 43-48.

Swerdlow SH, Campo E, Harris NL, et al. (eds.) WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues Lyon: IARC; 2008.

Bennet JM, Catovsky D, Daniel MT, Flandrin G, Galton DAG, Gralnick HR, Sultan C. Proposals for the classification of acutemyeloidleukemias. Br J Haematol 1976; 33: 451-458.

Jennings CD, Foon KA. Recent advances in flow cytometry: application to the diagnosis of hematologic malignancy. Blood 1997; 90: 2863-2892.

Shaffer LG, Tommerup N. ISCN 2005: an International System for Human Cytogenetic Nomenclature. Basal. Karger Publishers; 2005.

Fischer L, Gokbuget N, Schwartz S, BurmeisterT, Rieder H, Bruggemann M, Hoelzer D, and Thiel E. CD56 expression in T-cell acute lymphoblastic leukemia is associated with non-thymic phenotype and resistance to induction therapy but no inferior survival after risk-adapted therapy. Haematologica 2009; 94(2): 224-229.

Montero I, Rios E, Parody R, Perez-Hurtado JM, Martin-NoyaA, Rodriguez JM. CD56 in T-cell acute lymphoblastic leukaemia: a malignant transformation of an early myeloid-lymphoid progenitor? Haematologica 2003; 88(9): E127-E128.

Yang DH, Lee JJ, Mun YC, Shin HJ, Kim YK, Cho SH, Chung IJ, Seong CM, Kim HJ. Predictable prognostic factor of CD56 expression in patients with acute myeloid leukemia with t(8:21) after high dose cytarabine or allogeneic hematopoietic stem cell transplantation. Am J Hematol 2007; 82: 1-5

Baer MR, Stewart CC, Lawrence D, Arthur DC, Byrd JC, Davey FR, Schiffer CA, Bloomfield CD. Expression of the neural cell adhesion molecule CD56 is associated with short remission duration and survival in acute myeloid leukemia with t(8;21)(q22;q22). Blood 1997; 90: 1643-1648.

Di Bona E, Sartori R, Zambello R, Guercini N, Madeo D, Rodeghiero F. Prognostic significance of CD56 antigen expression in acute myeloid leukemia. Haematologica 2002; 87: 250-256.

Iriyama N, Hatta Y, Takeuchi J, Ogawa Y, Ohtake S, Sakura T, Mitani K, Ishida F, Takahashi M, Maeda T, Izumi T, Sakamaki H, Miyawaki S, Honda S, Miyazaki Y, Taki T, Taniwaki M, Naoe T. CD56 expression is an independent prognostic factor for relapse in acute myeloid leukemia with t(8;21). Leuk Res 2013; 37: 1021-1026.

Montesinos P, Rayon C, Vellenga E, Brunet S, Gonzalez J, Gonzalez M, et al. Clinical significance of CD56 expression in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline-based regimens. Blood 2011; 117: 1799-1805.

Raspadori D, Lenoci M, Rondelli D, Testoni N, Nardi G, Sestigiani C. CD56 antigenic expression in acute myeloid leukemia identifies patients with poor clinical prognosis. Leukemia 2001; 15: 1161-1164.

Suvannasankha A, Minderman H, O'Loughlin KL, Sait SN, Stewart CC, Greco WR, Baer MR. Expression of the neural cell adhesion molecule CD56 is not associated with P-glycoprotein overexpression in core-binding factor acute myeloid leukemia. Leuk Res 2004; 28: 449-455.

Gattenloehner S, Chuvpilo S, Langebrake C, Dirk Reinhardt D, Muller-Hermelink H, Serfling E, Vincent A, Marx A. Novel RUNX1 isoforms determine the fate of acute myeloid leukemia. Blood 2007; 110: 2027-2033.

Published
2014-12-25
How to Cite
Ahmed, B. M., Kantoush, N. A., Ismail, M. A., & Abd-El Haleem, D. A. (2014). PROGNOSTIC SIGNIFICANCE OF CD56 EXPRESSION IN ACUTE LEUKEMIAS. International Journal of Medicine and Medical Research, 1(1). https://doi.org/10.11603/ijmmr.2413-6077.2015.1.2291