The CD56 antigen is normally expressed on natural-killer cells but has additionally been shown to be present on a variety of hematologic malignancies, including a subset of acute myelogenous leukemia (AML). There is disagreement, however, about its prognostic significance and its association with specific cytogenetic abnormalities. All clinical samples from June 1994, through September 1995, with increased myeloblasts were analyzed by multiparameter flow cytometry for anomalous expression of CD56. Patients with CD56+ blast cells were selected, and morphologic review was performed. Clinical information was obtained, and cytogenetic data were reviewed. Southern blot analysis to detect rearrangement of the mixed lineage leukemia (MLL) gene was performed when possible. The samples from 23 of 114 patients studied demonstrated anomalous expression of CD56 on myeloblasts, including patients with AML, myelodysplastic syndromes (MDS), and chronic myelogenous leukemia in blast crisis. The samples from 10 of 15 patients with CD56+ AML demonstrated at least partial monocytic differentiation. Dysplastic features were displayed in the samples of 12 patients. Correlation with specific cytogenetic abnormalities was not found. The MLL gene was rearranged in five of 18 patients. Seventeen patients have died, with a median survival of 4.6 months for patients with AML. Three have sustained a complete remission. One has findings of high-grade myelodysplastic syndrome. Two were unavailable for follow-up. Expression of CD56 was found in 20% of patients with increased myeloblasts, including patients with high-grade MDS, chronic myelogenous leukemia in blast crisis, and AML. This phenotype was associated with dysplasia, monocytic differentiation, and rearrangement of the MLL gene.

译文

CD56抗原通常在自然杀伤细胞上表达,但另外已显示出存在于多种血液系统恶性肿瘤中,包括急性骨髓性白血病 (AML) 的一部分。然而,关于其预后意义及其与特定细胞遗传学异常的关联存在分歧。通过多参数流式细胞术分析了所有来自1995年9月的成髓细胞增加的1994年6月的临床样本中cd56的异常表达。选择CD56 + 原始细胞的患者,并进行形态学检查。获得临床信息,并回顾细胞遗传学数据。在可能的情况下,进行Southern印迹分析以检测混合谱系白血病 (MLL) 基因的重排。来自114例患者中的23例的样本显示出CD56在成髓细胞上的异常表达,包括患有AML,骨髓增生异常综合征 (MDS) 和处于爆炸危机中的慢性粒细胞性白血病的患者。来自15例CD56 AML患者中的10例的样本显示出至少部分单核细胞分化。在12例患者的样本中显示出发育异常的特征。未发现与特定细胞遗传学异常的相关性。18例患者中有5例重排了MLL基因。17名患者死亡,AML患者的中位生存期为4.6个月。三个已经完全缓解。有人发现了高度骨髓增生异常综合征。两个无法进行随访。在20% 的成髓细胞增加的患者中发现了CD56的表达,包括患有高级别MDS,处于爆炸危机中的慢性粒细胞性白血病和AML的患者。这种表型与发育异常,单核细胞分化和MLL基因的重排有关。

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