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The Reliability and Specificity of c-kit for the Diagnosis
of Acute Myeloid Leukemias and Undifferentiated Leukemias
M.C. Bene,
M. Bernier,
R.O. Casasnovas,
G. Castoldi,
W. Knapp,
F. Lanza,
W.D. Ludwig,
E. Matutes,
A. Orfao,
C. Sperling, and
M.B. van't Veer for the European Group for the Immunological
Classification of Leukemias (EGIL)
From the GEIL-Laboratoire d'Immunologie, Faculte de Medicine, Nancy,
France; the Institute Jules Bordet, Brussels, Belgium; the Service
d'Hematologie, Dijon, France; the Institute of Haematology, University
of Ferrara, Ferrara, Italy; the Robert-Rossle-Clinic Charite, Humboldt
University of Berlin, Berlin, Germany; and the Academic Department of
Haematology and Cytogenetics, Royal Marsden Hospital, London, UK.
We document findings on c-kit (CD117) expression in 1,937 pediatric
and adult de novo acute leukemia cases, diagnosed in five single
European centers. All cases were well characterized as to the
morphologic, cytochemical, and immunologic features, according to the
European Group for the Immunological Classification of Leukemias
(EGIL). The cases included 1,103 acute myeloid leukemia (AML), 819 acute lymphoblastic leukemia (ALL), 11 biphenotypic acute leukemia
(BAL), and 4 undifferentiated (AUL). c-kit was expressed in 741 (67%)
AML cases, regardless of the French-American-British (FAB) subtype, one
third of BAL, all four AUL, but only in 34 (4%) of ALL cases. The
minority of c-kit+ ALL cases were classified as: T-cell
lineage (two thirds), mainly pro-T-ALL or T-I, and B lineage (one
third); cells from 62% of these ALL cases coexpressed other myeloid
markers (CD13, CD33, or both). There were no differences in the
frequency of c-kit+ AML or ALL cases according to age
being similar in the adult and pediatric groups. Our findings
demonstrate that c-kit is a reliable and specific marker to detect
leukemia cells committed to the myeloid lineage, and therefore should
be included in a routine basis for the diagnosis of acute leukemias to
demonstrate myeloid commitment of the blasts. c-kit expression should
score higher, at least one point, in the system currently applied to the diagnosis of BAL, as its myeloid specificity is greater than CD13
and CD33. Findings in ALL and AUL suggest that c-kit identifies a
subgroup of cases, which may correspond to leukemias either arising
from early prothymocytes and/or early hematopoietic cells, both
able to differentiate to the lymphoid and myeloid pathways.
Blood, Vol. 92 No. 2 (July 15), 1998:
pp. 596-599
© 1998 by the American Society of Hematology.
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