This study was registered with the UMIN Clinical Trials Registry (http://www.umin.ac.jp/ctrj/) under trial number: C000000206.
Expression of CD56 is an unfavorable prognostic factor for acute promyelocytic leukemia with higher initial white blood cell counts
Article first published online: 9 JAN 2014
© 2013 The Authors. Cancer Science published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Cancer Association.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Volume 105, Issue 1, pages 97–104, January 2014
How to Cite
Cancer Sci 105 (2014) 97–104
National Cancer Center Research and Development Fund (23-A-23). Japanese Ministry of Health, Labor and Welfare (Clinical Cancer Research 23-004 and 25100501). Project for Development of Innovative on Cancer Therapeutics (P-Direct).
- Issue published online: 24 JAN 2014
- Article first published online: 9 JAN 2014
- Accepted manuscript online: 10 NOV 2013 10:16PM EST
- Manuscript Accepted: 31 OCT 2013
- Manuscript Revised: 28 OCT 2013
- Manuscript Received: 7 MAY 2013
- National Cancer Center Research and Development. Grant Number: 23-A-23
- Japanese Ministry of Health, Labor and Welfare. Grant Numbers: 23-004, 25100501
- Project for Development of Innovative on Cancer Therapeutics (P-Direct)
- Acute promyelocytic leukemia;
- all-trans retinoic acid;
- CD56 expression;
- prognostic factor
Expression of CD56 has recently been introduced as one of the adverse prognostic factors in acute promyelocytic leukemia (APL). However, the clinical significance of CD56 antigen in APL has not been well elucidated. We assessed the clinical significance of CD56 antigen in 239 APL patients prospectively treated with all-trans retinoic acid and chemotherapy according to the Japan Adult Leukemia Study Group APL97 protocol. All patients were prospectively treated by the Japan Adult Leukemia Study Group APL97 protocol. The median follow-up period was 8.5 years. Positive CD56 expression was found in 23 APL patients (9.6%). Expression of CD56 was significantly associated with lower platelet count (P = 0.04), severe disseminated intravascular coagulation (P = 0.04), and coexpression of CD2 (P = 0.03), CD7 (P = 0.04), CD34 (P < 0.01) and/or human leukocyte antigen-DR (P < 0.01). Complete remission rate and overall survival were not different between the two groups. However, cumulative incidence of relapse and event-free survival (EFS) showed an inferior trend in CD56+ APL (P = 0.08 and P = 0.08, respectively). Among patients with initial white blood cell counts of 3.0 × 109/L or more, EFS and cumulative incidence of relapse in CD56+ APL were significantly worse (30.8% vs 63.6%, P = 0.008, and 53.8% vs 28.9%, P = 0.03, respectively), and in multivariate analysis, CD56 expression was an unfavorable prognostic factor for EFS (P = 0.04). In conclusion, for APL with higher initial white blood cell counts, CD56 expression should be regarded as an unfavorable prognostic factor.