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CD99 expression in T-lineage ALL: implications for flow cytometric detection of minimal residual disease

Leukemia volume 18, pages 703–708 (2004)Cite this article

Abstract

Expression of CD99 is higher on immature than on mature T cells. We postulated that this marker could be used to assess minimal residual disease (MRD) in T-lineage acute lymphoblastic leukemia (T-ALL). In diagnostic bone marrow (BM) samples from 27 children with T-ALL, expression of CD99 on leukemic lymphoblasts by flow cytometry was in median 7.7 times higher than on normal T lymphocytes from within the same sample. In 85% of cases, leukemic MFI values were higher than the mean MFI+2 s.d. of normal populations. We applied CD99 to study MRD in 39 follow-up samples from 15 consecutive T-ALL patients, and compared the results with those obtained with the well-established MRD-marker terminal deoxynucleotidyl transferase (TdT). Either antibody was combined in four-color flow cytometry with CD7, surfaceCD3, and cytoplasmicCD3. We found that CD99 was a valid complement to TdT in quantifying T-ALL MRD. Given a considerable interpatient variability, CD99 could be favorably used in nine patients, and TdT in other five patients. Both approaches showed a similar very low nonspecific background throughout 12 weeks from diagnosis (in median 0.002% of nucleated BM cells in patients with non-T ALL). We conclude that CD99 is a highly informative tool for MRD detection in T-ALL, bearing the advantage of surface expression in contrast to TdT.

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Acknowledgements

This study has been promoted by the International BFM Study Group under the direction of M Schrappe. We thank the participants of the Austrian BFM-Study Group (B Ausserer, FM Fink, H Haas, N Jones, R Jones, W Kaulfersch, G Müller, I Mutz, R Ploier, K Schmitt, O Stöllinger, and C Urban) for their close collaboration in providing BM and PB samples. In this respect, we are also grateful to the oncologists and the laboratory-team of the St Anna Kinderspital (in particular to S Juhasz, R Kornmüller, E Neidhart, and U Stalze). We also thank G Fritsch, D Scharner, C Eichstill, and A Schumich from the department of flow cytometry of the CCRI for continued technical support. We thank G Mann, N Mühlegger, and J Regelsberger from the Austrian BFM Study Group documentation center for providing the clinical data and U Pötschger for help with statistical analyses.

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Authors and Affiliations

  1. Children's Cancer Research Institute, St Anna Children's Hospital, Vienna, Austria

    M N Dworzak, G Fröschl, D Printz & H Gadner

  2. Department of Pediatrics, University of Padova, Padova, Italy

    L De Zen & G Basso

  3. Department of Pediatrics, Tettamanti Research Center, University of Milano-Bicocca, Ospedale San Gerardo, Monza, Italy

    G Gaipa & A Biondi

  4. Department of Hematology, Robert-Rössle-Clinic, Humboldt University, Berlin, Germany

    R Ratei & W-D Ludwig

Authors
  1. M N Dworzak
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  2. G Fröschl
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  3. D Printz
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  4. L De Zen
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  5. G Gaipa
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  7. G Basso
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  8. A Biondi
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  9. W-D Ludwig
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  10. H Gadner
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on behalf of the I-BFM-ALL-FCM-MRD-Study Group

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Correspondence to M N Dworzak.

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Dworzak, M., Fröschl, G., Printz, D. et al. CD99 expression in T-lineage ALL: implications for flow cytometric detection of minimal residual disease. Leukemia 18, 703–708 (2004). https://doi.org/10.1038/sj.leu.2403303

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