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Acute myeloid leukemia M4 with bone marrow eosinophilia (M4Eo) and
inv(16)(p13q22) exhibits a specific immunophenotype with CD2 expression
HJ Adriaansen, PA te Boekhorst, AM Hagemeijer, CE van der Schoot, HR Delwel and JJ van Dongen
Department of Immunology, University Hospital Dijkzigt/Erasmus University,
Rotterdam, The Netherlands.
Extensive immunologic marker analysis was performed to characterize the
various leukemic cell populations in eight patients with inv(16)(p13q22) in
association with acute myeloid leukemia with abnormal bone marrow
eosinophilia (AML-M4Eo). The eight AML cases consisted of heterogeneous
cell populations; mainly due to the presence of multiple subpopulations,
which varied in size between the patients. However, the immunophenotype of
these subpopulations was comparable, independent of their relative sizes.
Virtually all AML-M4Eo cells were positive for the pan-myeloid marker CD13.
In addition, the AML were partly positive for CD2, CD11b, CD11c, CD14,
CD33, CD34, CD36, CDw65, terminal deoxynucleotidyl transferase (TdT), and
HLA-DR. Double immunofluorescence stainings demonstrated coexpression of
the CD2 antigen and myeloid markers and allowed the recognition of multiple
AML subpopulations. The CD2 antigen was expressed by immature AML cells
(CD34+, CD14-) and more mature monocytic AML cells (CD34-, CD14+), whereas
TdT expression was exclusively found in the CD34+, CD14- cell population.
The eight AML-M4Eo cases not only expressed the CD2 antigen, but also its
ligand CD58 (leukocyte function antigen-3). Culturing of AML-M4Eo cell
samples showed a high spontaneous proliferation in all three patients
tested. Addition of a mixture of CD2 antibodies against the T11.1, T11.2,
and T11.3 epitopes diminished cell proliferation in two patients with high
CD2 expression, but no inhibitory effects were found in the third patient
with low frequency and low density of CD2 expression. These results suggest
that high expression of the CD2 molecule in AML-M4Eo stimulates
proliferation of the leukemic cells, which might explain the high white
blood cell count often found in this type of AML.
Volume 81,
Issue 11,
pp. 3043-3051,
06/01/1993
Copyright © 1993 by The American Society of Hematology
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