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  • Title: [Prognostic Value of CD123 in Acute Myeloid Leukemia Patients with Intermediate Risk in Normal Karyotype].
    Author: Zhang Y, Liu RY, Wang SJ, Wang C, Zhang QT, He C, Xie XS, Wan DM, Jiang ZX, Liu YF.
    Journal: Zhongguo Shi Yan Xue Ye Xue Za Zhi; 2020 Dec; 28(6):1880-1884. PubMed ID: 33283714.
    Abstract:
    OBJECTIVE: To investigate the expression of CD123 in patients with acute myeloid leukemia (AML) and its relationship between clinical features, concomitant fusion gene or gene mutation, efficacy and prognosis. METHODS: 365 patients with newly diagnosed AML (except M3) treated in the First Affiliated Hospital of Zhengzhou University were enrolled and retrospective analysis, and multi-parameter flow cytometry was performed to detect the expression of CD123 in myeloid leukemia cell population. CD123≥20% was defined as positive. Clinical features, concomitant fusion gene or gene mutation, efficacy and prognosis of CD123+ and CD123- patients were compared and analyzed. RESULTS: The positive rate of CD123 in 365 newly diagnosed AML patients was 38.9%. Compared with the CD123- group, the white blood cell count (WBC), lactate dehydrogenase (LDH) level and bone marrow blast cell ratio were higher in the CD123+ group, and the ratio of NPM1 and DMNT3a gene mutations and the CBFβ-MYH11 fusion gene was significantly increased, while the ratio of CEBPA gene mutation and AML-ETO fusion gene was significantly reduced. The rate of first inducing complete remission and total remission in CD123+ group was significantly lower than that in CD123- group. There was no significant difference in recurrence rate between the two groups (P>0.05). Survival analysis showed that in 77 AML patients with normal karyotype and intermediate risk, the 2-year overall survival (OS) rate and event-free survival (EFS) rate of the CD123+ group were significantly lower than those of the CD123- group. Multivariate analysis showed that CD123 was an independent prognostic risk factor for OS and EFS in AML patients with normal karyotype and intermediate risk. CONCLUSION: CD123 positive indicates that AML patients have higher tumor burden and are more difficult to reach remission. It is an independent risk factor for OS and EFS in patients with normal karyotype and intermediate risk, which is important to evaluate the prognosis of patients with AML without specific prognostic marker. 题目: CD123在正常核型中危急性髓系白血病患者中的预后意义. 目的: 探讨CD123在急性髓系白血病（AML）患者中的表达及其与临床特征、是否伴随融合基因或基因突变、疗效和预后的关系。. 方法: 回顾性分析郑州大学第一附属医院收治的365例初诊AML（M3除外）患者, 采用多参数流式细胞术检测骨髓白血病细胞群中CD123的表达情况, 阳性定义为≥20%的细胞表达CD123抗原; 对CD123+和CD123-患者的临床特征、是否伴随融合基因或基因突变、及其疗效和预后进行比较分析。. 结果: 365例初诊AML患者中, CD123阳性率为38.9%, 与CD123-组比较, CD123+组初诊时白细胞计数、乳酸脱氢酶水平及骨髓原始细胞比例均更高, NPM1和DMNT3a基因突变及CBFβ-MYH11融合基因发生率显著升高, 而CEBPA基因突变和AML-ETO融合基因发生率显著降低。CD123+组首次诱导完全缓解率及总缓解率均显著低于CD123-组, 2组复发率无显著性差异（P>0.05）。生存分析显示, 在77例正常核型中危AML患者中, CD123+组2年总生存（OS）及无事件生存（EFS）均显著低于CD123-组。多因素分析显示, CD123是正常核型中危AML患者OS和EFS的独立预后不良因素。. 结论: CD123+提示AML患者肿瘤负荷较高、难缓解, 是影响正常核型中危AML患者 OS和EFS的独立危险因素, 对评估无特殊预后标记AML患者的预后有重要意义。.
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