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Keywords:

  • APL;
  • CD34;
  • prognosis

Abstract

This study investigated the clinical characteristics and prognostic relevance of CD34 expression in 47 patients with acute promyelocytic leukemia (APL), showing t(15;17) or PML/RARα. Ten (21.3%) of the APL patients were CD34+. CD34 expression was associated with hypogranular morphology (P = 0.002) and hyperleukocytosis (P = 0.015). However, there were no statistically significant differences in age, sex, hemoglobin level, platelet count, or percentage of blasts between the CD34+ and CD34 APL groups. Multiplex RT-PCR analysis showed that the L-form (BCR1) and S-form (BCR3) were correlated with CD34 APL and CD34+ APL, respectively. Despite the lack of a difference in the complete remission rate, overall survival (OS) and disease-free survival (DFS) were significantly lower in the CD34+ group than in the CD34 group (P = 0.012 and P = 0.0051, respectively). By multivariate analysis, the CD34+ group showed a significant independent variable in DFS compared with the CD34 group, but this was not demonstrated for OS. In conclusion, CD34 expression in APL is a unique clinical feature associated with leukocytosis and atypical morphology with hypogranular pattern and is associated with a poor clinical outcome. Am. J. Hematol. 73:149–153, 2003. © 2003 Wiley-Liss, Inc.