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Blood, Vol. 94 No. 2 (July 15), 1999: pp. 832-833

CORRESPONDENCE

AC133 Antigen Expression Is Not Restricted to Acute Myeloid Leukemia Blasts But Is Also Found on Acute Lymphoid Leukemia Blasts and on a Subset of CD34+ B-Cell Precursors


    LETTER

To the Editor:

Human AC133 antigen is a 5-transmembrane molecule that belongs to the prominin family.1-4 In the hematopoietic system, AC133 expression is restricted to a subset of CD34+ progenitor/stem cells1 and to leukemic blasts from patients with acute myeloid leukemia (AML).2,5-7 Controversy exists whether the AC133 antigen is also expressed on acute lymphoblastic leukemia (ALL) blasts. One group described low levels of AC133 antigen expression on the blasts of some ALL samples,2 whereas 3 other groups reported the exclusive expression of this molecule on AML blasts.5-7 Using multiparameter flow cytometry, we analyzed the correlated expression of AC133 antigen and CD34 in 23 AML and 9 ALL samples from adult patients, as well as on the surface of normal CD34+ bone marrow cells. Table 1 shows the distribution of AC133 antigen and CD34 on leukemic blasts in correlation to their morphological classification. In line with previous reports, the majority of CD34+ AML samples (15/18 [83%]) coexpressed the AC133 antigen. Four of the 5 tested CD34- AML samples (80%) were also AC133+. Notably, these samples exclusively displayed the M4/M5 French-American-British (FAB) subtypes. Four of 10 CD34+AC133+ AML samples of the M1/M2 subtypes and 1 of 6 of the M4/M5 subtypes expressed high levels of AC133 antigen (mean log fluorescence intensity between the second and third decade). In addition, 1 of 4 CD34-AC133+ AML samples were also AC133bright. Representative plots of a CD34+AC133bright FAB M2 and a CD34-AC133dim FAB M4 sample are shown in Fig 1. In contrast to other reports, our data neither confirm that AC133bright cells are exclusively found in M4/M5 AML subtypes2 nor that AC133bright blasts resemble exclusively the most immature FAB types,7 but rather suggest that high levels of AC133 antigen expression is observed on myeloid leukemic blasts of all FAB subtypes.

                              
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Table 1. Expression of AC133 Antigen and CD34 on ALL and AML



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Fig 1. Coexpression of AC133 antigen and CD34 on leukemic blasts. Representative AML and ALL blasts were stained with anti-CD34-FITC (horizontal axis) and AC133-PE (vertical axis) and analyzed on a FACSCalibur flow cytometer. The mean fluorescence intensity values are derived from the populations gated on AC133+ cells.

Table 1 also demonstrates that 3 of 6 C-ALL, 1 of 1 pro-B ALL, and 1 of 2 T-ALL samples were AC133+. These data are in line with the observations of Miraglia et al,2 who found AC133 antigen expression on 4 of 6 ALL samples, but do not support the findings of Snell et al,7 who could not detect AC133 antigen expression on any of the 17 tested ALL samples. In contrast to Miraglia et al,2 we found high levels of AC133 expression in some B-lymphoid ALL samples (2/7). Figure 1 shows that 1 AC133bright sample was of the C-ALL and 1 was of the pro-B ALL phenotype. Notably, the AC133bright blasts of the pro-B ALL sample were heterogeneous with regard to CD34 expression. However, whether the CD34+AC133bright and the CD34-AC133bright represent populations of different maturational stages has yet to be determined.

To analyze whether AC133+ B-lymphoid cells exist also among nonleukemic hematopoietic precursor cells, normal bone marrow cells enriched for CD34+ cells by MACS technology were stained with anti-CD34-peridine chlorophyll protein (PerCP), AC133-phycoerythrin (PE), and anti-CD10-fluorescein isothiocyanate (FITC) or anti-CD19-FITC, respectively, and analyzed on a FACSCalibur flow cytometer. Figure 2 shows that the majority of the CD34+CD10+ and CD34+CD19+ cells (34.8% v 29.4%) are AC133-. However, a minor CD34+CD10+ and CD34+CD19+ B-cell precursor population exists (15.1% v 5.9%) that is also AC133+ and may represent the normal counterpart of AC133+ ALL cells. Our data suggest that AC133 antigen is not only expressed on stem cells and myeloid progenitor cells and their leukemic counterparts,1,2 but also on ALL blasts and normal CD34+ B-lymphoid precursor cells.


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Fig 2. Coexpression of AC133 and CD10 or CD19 on CD34+ bone marrow cells. Mononuclear bone marrow cells were enriched for CD34+ cells by MACS and stained with anti-CD34-PECY5, AC133-PE, and anti-CD10-FITC or anti-CD19-FITC, respectively. The plots show expression of AC133 antigen versus CD10 or CD19 on cells gated on CD34+ cells.


    ACKNOWLEDGMENT

These studies were supported by the Deutsche Forschungsgemeinschaft (SFB 510, project A1), by a grant from the Federal Ministry of Education and Research and the Interdisciplinary Clinical Research Center (project II A1), and by a grant from the Deutsche Krebshilfe (W16/94 Br1).

Hans-Jörg Bühring
Martina Seiffert
Anke Marxer
Burkhard Weiß
Christoph Faul
Lothar Kanz
Wolfram Brugger
Department of Medicine
Division of Hematology and Oncology
University of Tübingen
Tübingen, Germany


    REFERENCES

1. Yin AH, Miraglia S, Zanjani ED, Almeida-Porada G, Ogawa M, Leary AG, Olweus J, Kearny J, Buck DW: AC133, a novel marker for human hematopoietic stem and progenitor cells. Blood 90:5002, 1997[Abstract/Free Full Text]

2. Miraglia S, Godfrey W, Yin AH, Atkins K, Warnke R, Holden JT, Bray RA, Waller EK, Buck DW: A novel five-transmembrane hematopoietic stem cell antigen: Isolation, characterization, and molecular cloning. Blood 90:5013, 1997[Abstract/Free Full Text]

3. Corbeil D, Röper K, Weigmann A, Huttner WB: AC133 hematopoietic stem cell antigen: Human homologue of mouse kidney prominin or distinct member of a novel protein family? Blood 91:2625, 1998[Free Full Text] (letter)

4. Miraglia S, Godfrey W, Buck DW: A response to AC133 hematopoietic stem cell antigen: Human homologue of mouse kidney prominin or distinct member of a novel protein family? Blood 91:4390, 1998[Free Full Text] (letter)

5. Horn PA, Tesch H, Staib P, Kube D, Diel V, Voliotis D: Expression of AC133, a novel hematopoietic precursor antigen, on acute myeloid leukemia cells. Blood 93:1435, 1999[Free Full Text] (letter)

6. Kratz-Albers K, Zühlsdorf M, Leo R, Berdel WE, Büchner T, Serve H: Expression of AC133, a novel stem cell marker, on human leukemic blasts lacking CD34 antigen and on a human CD34+ leukemic cell line: MUTZ-2. Blood 92:4485, 1998[Free Full Text] (letter)

7. Snell V, Jackson E, Buck D, Andreeff M: Expression of the AC133 antigen in leukemic and normal progenitors. Blood 92:119a, 1998 (abstr, suppl 1)
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