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Blood, 15 February 2007, Vol. 109, No. 4, pp. 1720-1727.
Prepublished online as a Blood First Edition Paper on October 26, 2006; DOI 10.1182/blood-2006-04-018143.
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Submitted April 19, 2006
Accepted August 29, 2006
Gene expression profiling and array-based CGH classify CD4+CD56+ hematodermic neoplasm and cutaneous myelomonocytic leukemia as distinct disease entities
Remco Dijkman, Remco van Doorn, Karoly Szuhai, Rein Willemze, Maarten H Vermeer, and Cornelis P Tensen*
Department of Dermatology, Leiden University Medical Center, Leiden, Netherlands
Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, Netherlands
* Corresponding author; email: c.p.tensen{at}lumc.nl.
CD4+CD56+ hematodermic neoplasm (CD4+CD56+HN) is an aggressive hematopoietic malignancy with distinct clinicopathologic and immunophenotypical features that commonly involves the skin, bone marrow and blood. Differentiation from cutaneous myelomonocytic leukemia (c-AML) may be exceedingly difficult and requires extensive phenotyping. The molecular mechanisms involved in the development of CD4+CD56+HN are largely unresolved. Moreover, recurrent chromosomal alterations have not yet been precisely defined in CD4+CD56+HN and c-AML. In the present study an integrated genomic analysis using expression profiling and array-based CGH was performed on lesional skin biopsy samples of patients with CD4+CD56+HN and c-AML. Our results demonstrate that CD4+CD56+HN and c-AML show distinct gene expression profiles and distinct patterns of chromosomal aberrations. CD4+CD56+HN is characterized by recurrent deletion of regions on chromosome 4 (4q34), chromosome 9 (9p13-p11 and 9q12-q34) and chromosome 13 (13q12-q31), that contain several tumor suppressor genes with diminished expression (Rb1, LATS2). Elevated expression of the oncogenes HES6, RUNX2 and FLT3 was found, but was not associated with genomic amplification. We noted high expression of various plasmacytoid dendritic cell (pDC)-related genes, pointing to the cell of origin of this malignancy.

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