Blood, Vol. 92 No. 3 (August 1), 1998:
pp. 795-801
Expression of Myeloid Markers Lacks Prognostic Impact in Children
Treated for Acute Lymphoblastic Leukemia: Italian
Experience in AIEOP-ALL 88-91 Studies
Maria Caterina Putti,
Roberto Rondelli,
Maria Grazia Cocito,
Maurizio Aricó,
Laura Sainati,
Valentino Conter,
Cesare Guglielmi,
Angelo Cantú-Rajnoldi,
Rita Consolini,
Andrea Pession,
Luigi Zanesco,
Giuseppe Masera,
Andrea Biondi, and
Giuseppe Basso
From the Dipartimento di Pediatria, Universitá di Padova,
Padova; III Clinica Pediatrica, Universitá di Bologna, Bologna;
Clinica Pediatrica, Universitá di Pavia, Pavia; Clinica
Pediatrica Universitá di Milano-Ospedale San Gerardo, Monza;
Cattedra di Ematologia, Universitá La Sapienza,
Roma; Clinica Pediatrica, Universitá di Pisa, Pisa;
Dipartimento di Pediatria, Universitá di Torino, for the Italian
Association for Pediatric Hematology and Oncology (AIEOP).
The importance of coexpression of myeloid antigens in childhood
acute lymphoblastic leukemia (ALL) has long been debated; results are
conflicting. We studied children with ALL treated at Italian
Association for Pediatric Hematology-Oncology (AIEOP) institutions over
6 years with Berlin-Frankfurt-Muenster (BFM)-based protocols and have analyzed the incidence of coexpression of six MyAg (CD11b, CD13, CD14, CD15, CD33, CD65w) to determine
its prognostic impact. Criteria for MyAg coexpression
(MyAg+ALL) included positivity to one or more MyAg on at
least 20% of blasts and confirmation of coexpression at
double-fluorescence analysis. A total of 291 of 908 cases were
MyAg+ALL (32%). Incidence was similar in B-ALL and
T-ALL; among common, pre-B, and pre-pre-B-ALL. CD13 and CD33 were most
common. Patients with MyAg+ALL had presenting features
similar to MyAg
ALL. They entered standard or
intermediate risk protocols more frequently and had better prednisone
response, but similar complete remission rates. Six-year event-free
survival (EFS) was 69.0% in 291 MyAg+ALL
cases and 65.3% in 617 MyAgALL cases, without
significant difference. Cases expressing two or more MyAg presented
similar clinical features and treatment response.
MyAg+ALL had worse EFS only in infants (0% v
47%) (P = .01). Therefore, in this series of homogeneously
diagnosed and treated ALL, coexpression of MyAg was not associated with
prognostic significance, without relevance for clinical purposes or for
patient stratification, except for infants.
© 1998 by The American Society of Hematology.
