Expression of CD56 is a risk factor for acute lymphocytic leukemia with central nervous system involvement in adults

ABSTRACT Objective: To gain further insights into the predisposing risk factors for central nervous system (CNS) involvement in patients with acute lymphocytic leukemia (ALL), the impact of CD56 expression in these patients was investigated. Methods: We reviewed the clinical features of CD56 expression in 588 consecutive ALL patients treated with systemic chemotherapy regimens between 2000 and 2014. The categorical data from CD56+ ALL patients were compared with those from CD56− ALL patients. Results: Among the 588 patients studied, 18.9% showed CD56 expression. The expression was significantly associated with CD33+, CD10−, CD15+, TdT−, and CD5+ immunophenotypes. After systemic chemotherapy, 8.8% patients showed CNS involvement, of which 3.2% exhibited combined recurrences and 5.6% exhibited isolated CNS involvement. The 5-year event-free survival was significantly lower for patients with CD56+ immunophenotype compared with patients with CD56− immunophenotype (22.5% vs. 32.7%, P = 0.04). Cumulative incidences of CNS involvement were significantly greater in the CD56+ cohort compared with the CD56− cohort (14.4% vs. 7.5%, P = 0.02). Multivariate analysis revealed CD56 expression to be statistically significant risk factors for CNS involvement. Conclusion: CD56 expression should be regarded as an independent risk factor for ALL with CNS involvement in adults.

[1]  D. Machin,et al.  Estimating sample size in the presence of competing risks – Cause-specific hazard or cumulative incidence approach? , 2018, Statistical methods in medical research.

[2]  B. Leber,et al.  Long-term outcome of a pediatric-inspired regimen used for adults aged 18–50 years with newly diagnosed acute lymphoblastic leukemia , 2014, Leukemia.

[3]  D. Marks,et al.  Allogeneic hematopoietic cell transplantation in adult patients with acute lymphoblastic leukemia. , 2014, Hematology/oncology clinics of North America.

[4]  Y. Mi.  [Expert consensus on adult acute lymphoblastic leukemia in China-interpretation of diagnosis and prognosis stratification]. , 2013, Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi.

[5]  Z. Fan,et al.  The effect of imatinib therapy on the outcome of allogeneic stem cell transplantation in adults with Philadelphia chromosome-positive acute lymphoblastic leukemia , 2013, Hematology.

[6]  A. Órfão,et al.  Mixed phenotype acute leukemia (MPAL): clinical and laboratory features and outcome in 100 patients defined according to the WHO 2008 classification Authors: , 2011 .

[7]  D. Hoelzer,et al.  Modern therapy of acute lymphoblastic leukemia. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[8]  Claire Schwab,et al.  Acute lymphoblastic leukaemia. , 2011, Methods in molecular biology.

[9]  J. Esteve,et al.  Central nervous system involvement at first relapse in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline monochemotherapy without intrathecal prophylaxis , 2009, Haematologica.

[10]  H. Dombret,et al.  Central nervous system involvement in adult acute lymphoblastic leukemia at diagnosis and/or at first relapse: results from the GET-LALA group. , 2007, Leukemia research.

[11]  Robert E. Lewis,et al.  Aberrant Myeloid Marker Expression in Precursor B‐Cell and T‐Cell Leukemias , 2007, Experimental and molecular pathology.

[12]  F. Giles,et al.  Treatment of acute lymphoblastic leukaemia : a new era. , 2007, Drugs.

[13]  E. Thiel,et al.  CD10- pre-B acute lymphoblastic leukemia (ALL) is a distinct high-risk subgroup of adult ALL associated with a high frequency of MLL aberrations: results of the German Multicenter Trials for Adult ALL (GMALL). , 2005, Blood.

[14]  K. Murai,et al.  Clinical and Biological Significance of CD56 Antigen Expression in Acute Promyelocytic Leukemia , 2004, Leukemia & lymphoma.

[15]  H. Yarmohammadi,et al.  An analysis of prognostic factors and the five-year survival rate in childhood acute lymphoblastic leukemia. , 2002, Medical science monitor : international medical journal of experimental and clinical research.

[16]  H. Kantarjian,et al.  Central nervous system relapse in adults with acute lymphoblastic leukemia , 2002, Cancer.

[17]  D. Neuberg,et al.  Rare adult acute lymphocytic leukemia with CD56 expression in the ECOG experience shows unexpected phenotypic and genotypic heterogeneity , 2001, American journal of hematology.

[18]  F. Lo Coco,et al.  CD56 expression is an indicator of poor clinical outcome in patients with acute promyelocytic leukemia treated with simultaneous all-trans-retinoic acid and chemotherapy. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  B. Pollock,et al.  Improved survival of children with isolated CNS relapse of acute lymphoblastic leukemia: a pediatric oncology group study . , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[20]  D. Catovsky,et al.  Definition of acute biphenotypic leukemia. , 1997, Haematologica.

[21]  A Orfao,et al.  Proposals for the immunological classification of acute leukemias. European Group for the Immunological Characterization of Leukemias (EGIL). , 1995, Leukemia.

[22]  T. Tsuruo,et al.  Role of aminopeptidase N (CD13) in tumor‐cell invasion and extracellular matrix degradation , 1993, International journal of cancer.

[23]  I. Weissman,et al.  Homing receptors and metastasis. , 1988, Advances in cancer research.

[24]  M. Langenhuijsen,et al.  Motility of leukaemic cells in acute leukaemia related to tumour mass, maturation and FAB classification. , 1988, Acta haematologica.

[25]  D. Kamat,et al.  Central nervous system and testicular involvement in acute lymphoblastic leukaemia. , 1985, The Journal of the Association of Physicians of India.