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Prognostic significance of natural killer expression in Egyptian pediatric acute myeloid leukemia



Prognostic significance of natural killer expression in Egyptian pediatric acute myeloid leukemia



Journal of Clinical Oncology 23(16_Suppl): 8542-8542



NlmCategory="UNASSIGNED">8542 Background and Objectives: Expression of CD56 and CD16, Natural Killer (NK) associated antigens, has been reported in several hematopoietic malignancies including acute myeloid leukemia (AML). It has been claimed to be a bad prognostic parameter in adult AML; no data is available for pediatrics. The aim of this study is to evaluate the significance of CD56 and/or CD16 expression in pediatric AML. 305 consecutive de novo pediatric AML patients presented to the National Cancer Institute, Egypt, were evaluated for the expression of CD56 and/or CD16 using multicolor flow cytometry (coulter X) at a cutoff of 20% (as reported in literature). Complete clinical data were available for 163 cases. All patients received the same treatment protocol: induction therapy consisting of Cytarabine 100 mg/m2/d 24 hrs infusion d1-2; 100 mg/m2 IV q12 hrs d3-8, Daunorubicin 25 mg/m2 d3-5, Etoposide 100 mg/m2 d6-8 followed by another course as consolidation, then four courses of MIDAC as continuation therapy (Mitoxantrone 10 mg/m2 d1-3 and intermediate dose Cytarabine 1g/m2 q12 hrs d1-3). NK expression was correlated to clinical, hematological and immunophenotypic parameters as well as to treatment outcome. The frequency of CD56 and/or CD16 expression was found to be 20.7%. Among the studied group NK antigen (CD56 and/or CD16) was positive in 48/163 cases; 19 were +ve for CD56, 10 for CD16 and 20 were not separately tested for CD56 or CD16. Neither the expression of NK antigens in the whole group nor CD56 positivity alone had any significant association with age, sex, white blood cell count, FAB or phenotypic markers including CD2, CD7, CD34, HLA-DR and P-gp expression. CD16 was significantly associated with M4-M5 subtypes (P=0.04, chi square). For the whole group, NK expression had no significant impact on complete remission rate (p=0.19) or duration (3-year DFS 23.6% vs 36.7% for +ve and -ve cases respectively, log rank p=0.32). CD56 had no impact on clinical outcome, while CD16 had significant impact on failure to achieve induction remission (55.6% for CD16+ vs 22.9% for CD16- cases; p=0.03 chi square). CD16 rather than CD56 might have prognostic impact in pediatric AML. Further study on a larger scale is recommended. No significant financial relationships to disclose.

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Accession: 058637220

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PMID: 27944683


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