PMID- 12682628
OWN - NLM
STAT- MEDLINE
DCOM- 20030505
LR  - 20131121
IS  - 0887-6924 (Print)
IS  - 0887-6924 (Linking)
VI  - 17
IP  - 4
DP  - 2003 Apr
TI  - HLA-DR antigen-negative acute myeloid leukemia.
PG  - 707-15
AB  - Human leukocyte antigen (HLA) Class II antigens are variably expressed on acute 
      myeloid leukemia (AML) blasts. The biological and clinical significance of HLA 
      Class II antigen expression by AML cells is not known. Therefore, we sought to 
      characterize cases of AML without detectable HLA-DR expression. Samples from 248 
      consecutive adult AML patients were immunophenotyped by multiparameter flow 
      cytometry at diagnosis. HLA-DR antigens were not detected on AML cells from 43 
      patients, including 20 with acute promyelocytic leukemia (APL), and 23 with other 
      subtypes of AML. All APL cases had t(15;17), but there were no characteristic 
      chromosome abnormalities in non-APL cases. No direct expression of other antigens 
      was identified in HLA-DR-negative APL and non-APL cases. Interestingly, cells 
      from three HLA-DR-negative non-APL patients had similar morphology to that of the 
      hypogranular variant of APL. This morphology, however, was not present in any 
      HLA-DR-positive AML cases. Treatment response was similar in the 23 
      HLA-DR-negative non-APL and the 205 HLA-DR-positive patients. Finally, relapse 
      was infrequently associated with changes in HLA-DR antigen expression, as the 
      HLA-DR antigen was lost at relapse in only 4% of HLA-DR-positive cases, and was 
      gained at relapse in only 17% of HLA-DR-negative cases. We conclude that 
      HLA-DR-negative AML includes approximately equal numbers of APL and non-APL 
      cases, and that the morphology of HLA-DR-negative non-APL cases can mimic the 
      hypogranular variant of APL. The diagnosis of APL cannot be based on morphology 
      and lack of HLA-DR antigen expression; rather, it requires cytogenetic or 
      molecular confirmation.
FAU - Wetzler, M
AU  - Wetzler M
AD  - Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
FAU - McElwain, B K
AU  - McElwain BK
FAU - Stewart, C C
AU  - Stewart CC
FAU - Blumenson, L
AU  - Blumenson L
FAU - Mortazavi, A
AU  - Mortazavi A
FAU - Ford, L A
AU  - Ford LA
FAU - Slack, J L
AU  - Slack JL
FAU - Barcos, M
AU  - Barcos M
FAU - Ferrone, S
AU  - Ferrone S
FAU - Baer, M R
AU  - Baer MR
LA  - eng
GR  - CA 16056/CA/NCI NIH HHS/United States
GR  - CA 67108/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - England
TA  - Leukemia
JT  - Leukemia
JID - 8704895
RN  - 0 (Antigens, Neoplasm)
RN  - 0 (HLA-DR Antigens)
RN  - 04079A1RDZ (Cytarabine)
RN  - ZRP63D75JW (Idarubicin)
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antigens, Neoplasm/*analysis
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Chromosome Aberrations
MH  - Cytarabine/administration & dosage
MH  - Disease-Free Survival
MH  - Female
MH  - Flow Cytometry
MH  - HLA-DR Antigens/*analysis
MH  - Humans
MH  - Idarubicin/administration & dosage
MH  - Immunophenotyping
MH  - Karyotyping
MH  - Leukemia, Myeloid/drug therapy/genetics/*metabolism/mortality
MH  - Male
MH  - Middle Aged
MH  - Neoplastic Stem Cells/chemistry/pathology
MH  - Prospective Studies
MH  - Recurrence
MH  - Treatment Outcome
EDAT- 2003/04/12 05:00
MHDA- 2003/05/06 05:00
CRDT- 2003/04/12 05:00
PHST- 2003/04/12 05:00 [pubmed]
PHST- 2003/05/06 05:00 [medline]
PHST- 2003/04/12 05:00 [entrez]
AID - 2402865 [pii]
AID - 10.1038/sj.leu.2402865 [doi]
PST - ppublish
SO  - Leukemia. 2003 Apr;17(4):707-15. doi: 10.1038/sj.leu.2402865.