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Previous Article | Table of Contents | Next Article 
Evidence for malignant transformation in acute myeloid leukemia at the
level of early hematopoietic stem cells by cytogenetic analysis of CD34+
subpopulations
D Haase, M Feuring-Buske, S Konemann, C Fonatsch, C Troff, W Verbeek, A Pekrun, W Hiddemann and B Wormann
Department of Hematology and Oncology, University of Gottingen, Germany.
Acute myeloid leukemia (AML) is a heterogenous disease according to
morphology, immunophenotype, and genetics. The retained capacity of
differentiation is the basis for the phenotypic classification of the bulk
population of leukemic blasts and the identification of distinct
subpopulations. Within the hierarchy of hematopoietic development and
differentiation it is still unknown at which stage the malignant
transformation occurs. It was our aim to analyze the potential involvement
of cells with the immunophenotype of pluripotent stem cells in the leukemic
process by the use of cytogenetic and cell sorting techniques. Cytogenetic
analyses of bone marrow aspirates were performed in 13 patients with AML
(11 de novo and 2 secondary) and showed karyotype abnormalities in 10 cases
[2q+, +4, 6p, t(6:9), 7, +8 in 1 patient each and inv(16) in 4 patients
each]. Aliquots of the samples were fractionated by fluorescence-activated
cell sorting of CD34+ cells. Two subpopulations, CD34+/CD38- (early
hematopoietic stem cells) and CD34+/CD38+ (more mature progenitor cells),
were screened for karyotype aberations as a marker for leukemic cells.
Clonal abnormalities and evaluable metaphases were found in 8 highly
purified CD34+/CD38- populations and in 9 of the CD34+/CD38- specimens,
respectively. In the majority of cases (CD34+/CD38-, 6 of 8 informative
samples; CD34+/CD38+, 5 of 9 informative samples), the highly purified
CD34+ specimens also contained cytogenetically normal cells. Secondary,
progression-associated chromosomal changes (+8, 12) were identified in the
CD34+/CD38- cells of 2 patients. We conclude that clonal karyotypic
abnormalities are frequently found in the stem cell-like (CD34+/CD38-) and
more mature (CD34+/CD38+) populations of patients with AML, irrespective of
the phenotype of the bulk population of leukemic blasts and of the primary
or secondary character of the leukemia. Our data suggest that, in AML,
malignant transformation as well as disease progression may occur at the
level of CD34+/CD38- cells with multilineage potential.
Volume 86,
Issue 8,
pp. 2906-2912,
10/15/1995
Copyright © 1995 by The American Society of Hematology

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