Expression of multiple leukemic stem cell markers is associated with poor prognosis in de novo acute myeloid leukemia

Leuk Lymphoma. 2018 Sep;59(9):2144-2151. doi: 10.1080/10428194.2017.1410888. Epub 2017 Dec 18.

Abstract

Leukemic stem cells (LSCs) play a crucial role in chemotherapy resistance in acute myeloid leukemia (AML). Although the association between the expression of individual LSC markers and poor prognosis has been reported, few studies have evaluated the prognostic effect of multiple LSC markers in patients with AML. Herein, we examined three LSC markers (CD25, CD96, and CD123) and the combined effect of their expression on clinical outcome. We retrospectively analyzed 80 adult patients with de novo AML who received intensive chemotherapy. Multiple LSC marker expression was significantly associated with shorter three-year overall survival (OS), compared with single or no LSC marker expression (18.2 vs. 65.0%, p < .001). Multivariate analysis showed that the expression of multiple LSC markers remained significant in terms of three-year OS (hazard ratio: 3.80, p = .001). Therefore, the combined evaluation of several LSC markers can predict the clinical outcome in patients with AML.

Keywords: Acute myeloid leukemia; immunophenotypic studies; leukemic stem cell.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Antigens, CD / metabolism
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor / metabolism*
  • Female
  • Humans
  • Interleukin-2 Receptor alpha Subunit / metabolism
  • Interleukin-3 Receptor alpha Subunit / metabolism
  • Kaplan-Meier Estimate
  • Leukemia, Myeloid / drug therapy*
  • Leukemia, Myeloid / metabolism
  • Leukemia, Myeloid / pathology
  • Male
  • Middle Aged
  • Neoplastic Stem Cells / drug effects*
  • Neoplastic Stem Cells / metabolism
  • Prognosis
  • Retrospective Studies
  • Young Adult

Substances

  • Antigens, CD
  • Biomarkers, Tumor
  • CD96 antigen
  • Interleukin-2 Receptor alpha Subunit
  • Interleukin-3 Receptor alpha Subunit