Aberrant Phenotypes in Acute Myeloid Leukemia and Its Relationship with Prognosis and Survival: A Systematic Review and Meta-Analysis

Lucio Henrique Sousa Pinheiro; Louise Dantas Trindade; Fernandes de Oliveira Costa; Nathanielly de Lima Silva; Alex Freire Sandes; Marco Antônio Prado Nunes; Cristiane Bani Correa; Carlos Arthur Cardoso Almeida; Geydson Silveira da Cruz; Divaldo Pereira de Lyra Junior; Dulce Marta Schimieguel

doi:10.18502/ijhoscr.v14i4.4484

Aberrant Phenotypes in Acute Myeloid Leukemia and Its Relationship with Prognosis and Survival: A Systematic Review and Meta-Analysis

Int J Hematol Oncol Stem Cell Res. 2020 Oct 1;14(4):274-288. doi: 10.18502/ijhoscr.v14i4.4484.

Affiliations

¹ Department of Pharmacy, Laboratory of Hematology, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil.
² Department of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
³ Department of Medicine, Hematology Course, Federal University of São Paulo, São Paulo, São Paulo, Brazil.
⁴ Department of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil.
⁵ Department of Morphology, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil.
⁶ Nursing and Pharmacy School, Federal University of Alagoas, Maceió, Alagoas, Brazil.
⁷ Hematologist, University Hospital, Federal University of Sergipe, Aracaju, Sergipe, Brazil.

Abstract

Background: The aim of this review was to evaluate the influence of aberrant phenotypes in prognosis and survival in acute myeloid leukemia (AML) patients by multiparametric flow cytometry. Materials and Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a review of PubMed, Scopus, Science Direct and Web of Science was carried out through 1998 to 2016, conducted by two reviewers independently, evaluating titles, abstracts and full-texts of the selected studies. Results: Ten studies were included on this review, in which the aberrant phenotype expression of 17 markers were detected in AML patients. From these, 11 aberrant phenotypes were associated with prognosis, which eight had shown negative impact on prognosis: CD7, CD56, CD15, CD2, CD3, CD90^low, CD123^high, CD117^high, and three others were associated with good prognosis: CD19, CD98^high and CD117⁺/CD15⁺. Meta-analysis showed that aberrant expression of CD56 as a poor prognostic marker with unfavorable outcomes is implicated in decreased overall survival in AML patients in 28 months (95% CI: 0.62 to 0.92). Conclusion: This was observed when there was association between CD56 expression and other prognostic factors, influencing on patients' management care and treatment.

Keywords: Aberrant phenotype; Acute myeloid leukemia; Immunophenotyping; Prognosis; Survival.

Publication types

Review