Impact of aberrant antigens expression on remission rate after first induction course of chemotherapy in de novo adult acute myeloid leukemia

Abstract

BACKGROUND: Aberrant antigen expression is an unexpected antigen that is detected on lineagein question without alteration of lineage definition. Immunophenotypic aberrancies are thought topredict treatment outcome in acute myeloid leukemia (AML). Some studies reported an adverseprognostic association, while others failed to show any association.AIM: To determine percentage of lymphoid antigens expression in adult AML patients and correlatethem with hematological parameters and response to induction chemotherapy protocol.SUBJECTS AND METHODS: Peripheral blood and bone marrow fresh samples from 81 casesof de novo AML were included in this study from November 2018 to October 2019. Hematologicalparameters were obtained from patients’ medical records. Aberrant antigens expression was detectedusing flow cytometry at the diagnosis. Patients were evaluated after one cycle of chemotherapyregarding remission status.RESULTS: Out of 81 patients, 60 patients had completed data for evaluation. CD7, CD19 expression,and co‑expression of CD7 and CD2 were found in 60%, 10.7%, and 10.7% of patients, respectively.Statistically significant associations were found between initial hemoglobin level and aberrantexpression as patients with aberrant expression have higher hemoglobin level than patients withoutaberrant expression. Complete remission was achieved in 29 out of 60 patients (48.3%) with standard3 and 7 protocol, whereas 31 patients did not achieve complete remission. There is no statisticallysignificant association between aberrant expression and treatment response to the first cycle ofchemotherapy protocol (P > 0.05).CONCLUSIONS: CD7 is the most frequent aberrant antigen expressed in this Iraqi AML patientgroup. Hemoglobin level was higher in patients with aberrant expression. No significant associationbetween aberrant expression and response to the first cycle of induction