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Lack of CD45 antigen on blast cells in childhood acute lymphoblastic
leukemia is associated with chromosomal hyperdiploidy and other favorable
prognostic features [see comments]
FG Behm, SC Raimondi, MJ Schell, AT Look, GK Rivera and CH Pui
Department of Pathology and Laboratory Medicine, St. Jude Children's
Research Hospital, Memphis, TN 38101.
The leukocyte common antigen (CD45) was detected on the surface of leukemic
cells in 217 (87%) of 249 cases of newly diagnosed childhood acute
lymphoblastic leukemia (ALL). All 55 cases of T-lineage ALL, compared with
159 of 191 B-lineage cases, expressed the CD45 antigen (P = .0005). The
frequency of CD45 expression did not differ between cases of early pre-B
(CD19+, cytoplasmic mu-) and pre-B (CD19+, cytoplasmic mu+) ALL. Cases of
ALL lacking CD45 had significantly lower leukocyte counts (P = .002) and
serum lactic dehydrogenase (LDH) levels (P = .007) and were more likely to
have leukemic cell hyperdiploidy greater than 50 (P less than .0001) or a
DNA index greater than 1.15 (P less than .0001), as compared with cases
positive for the antigen. Of the 130 patients whose follow-up duration was
sufficient for analysis of event-free survival, the 53 with the highest
levels of CD45 expression (greater than or equal to 90%) were the most
likely to have an adverse event on intensive multiagent chemotherapy.
Patients without detectable CD45 had a negligible risk of failure. This
study suggests a relationship between the expression of the CD45 antigen on
leukemic lymphoblasts and other biologic factors that influence prognosis
in ALL.
Volume 79,
Issue 4,
pp. 1011-1016,
02/15/1992
Copyright © 1992 by The American Society of Hematology
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