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Immunophenotype CD34 in AML

HLA-DR antigen-negative acute myeloid leukemia

Leukemia volume 17, pages 707–715 (2003)Cite this article

Abstract

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.

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Authors and Affiliations

  1. Department of Medicine, Leukemia Section, Roswell Park Cancer Institute, Buffalo, NY, USA

    M Wetzler, B K McElwain, A Mortazavi, L A Ford, J L Slack & M R Baer

  2. Laboratory of Flow Cytometry, Roswell

    C C Stewart

  3. Department of Pathology, Roswell Park Cancer Institute, Buffalo, NY, USA

    M Barcos

  4. Department of Cancer Prevention, Epidemiology and Biostatistics, Roswell Park Cancer Institute, Buffalo, NY, USA

    L Blumenson

  5. Department of Immunology, Roswell Park Cancer Institute, Buffalo, NY, USA

    M Wetzler & S Ferrone

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  1. M Wetzler
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Supported partially by National Cancer Institute Grants CA 16056 and CA 67108.

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Wetzler, M., McElwain, B., Stewart, C. et al. HLA-DR antigen-negative acute myeloid leukemia. Leukemia 17, 707–715 (2003). https://doi.org/10.1038/sj.leu.2402865

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