| Objective: The intercellular adhesion molecule-1(ICAM-1/CD54), lymphocytefunction-associated antigen-1(LFA-1/CD11a), neural cell adhesion molecule(NCAM/CD56) and CD44expression in bone marrow mononuclear cells ofhyperleukocytic acute myeloid leukemia was evaluated. We aim to explore thesignificance of these adhesion molecules in hyperleukocytic AML (HAML) andleukostasis.Methods: Bone marrow aspirate samples from53non-promyelocytic acute myeloidleukemia (AML) and20normal controls were collected. The expression of CD54,CD11a, CD56and CD44in bone marrow mononuclear cell (BMMNC) of acute myeloidleukemia (AML) and normal controls were detected by flow cytometry (FCM).Meanwhile, clinical information of these cases was collected, and the relationships of theadhesion molecules with the early mortality of AML during the first week and theincidence of leukostasis were analyzed.Results1The expression of adhesion molecules in bone marrow mononuclear cells1.1CD441) The positive rate of CD44in normal controls and the group of AML were100%,92.5%. Statistic analysis showed no obvious difference between the two groups(P>0.05); The positive rate of CD44in the group of the normal controls comparedwith non-hyperleukocytic AML (NHAML, WBC<100×109/L) and hyperleukocytic9/L) were100%,92.1%,93.3%; Statistic analysisshowed no obvious difference among these groups (P>0.05). The normal controlscompared with the group with leukostasis and the group without of leukostasis The positive rate of CD44in normal controls, the group without leukostasis and thegroup with leukostasis were100%,91.2%,100%; Statistic analysis showed noobvious difference among (P>0.05).2) The mean fluorescence intensity (MFI)of CD44in the group of AML was181.17±161.35which was much higher than that in the normal controls(93.66±24.42,P<0.05).The MFI of CD44in the group of NHAML, HAML, thegroup without leukostasis and the group with leukostasis were143.29±105.03,277.14±231.9,118.12±62.62and316.48±292.06, respectively. Statistic analysisshowed the CD44expression in the group of HAML is significantly higher than thatin NHAML and normal controls (P<0.017), and there was a positive correlationbetween the white blood cell counts and the mean fluorescence intensity of CD44inAML patients (r=0.446, P=0.001); but there was no obvious difference between thegroup with leukostasis and the group without leukostasis (P>0.017).1.2CD541) The positive rate of CD54in normal controls and the group of AML were70%,79.2%, respectively; Statistic analysis showed no obvious difference between thetwo groups (P>0.05). The positive rate of CD54in the group of the normal controls,NHAML and HAML were70%,78.9%,80%, respectively; Statistic analysisshowed no obvious difference among these groups (P>0.05). The positive rate ofCD54in normal controls, the group without leukostasis and the group withleukostasis were70%,82.4%,62.5%, respectively; Statistic analysis showed noobvious difference among these groups either (P>0.05).2) The MFI of CD54in the group of AML was149.77±117.85which was much lowerthan that in the normal controls (192.12±65.95, P<0.05). The MFI of CD54in thegroup of NHAML, HAML, the group without leukostasis and the group withleukostasis were144.39±105.03,163.41±148.84,137.04±101.29, and125.56±122.83, respectively. Statistic analysis showed the CD54expression in the group of NHAML is significantly lower than that in normal controls (P<0.017), butthere was no obvious difference between the group of HAML and NHAML(P>0.017), and the group of HAML the normal controls (P>0.017). There was noobvious difference among the group of normal controls, the group withoutleukostasis and the group with leukostasis either (P>0.05).1.3CD56The positive rate of CD56in normal controls and the group of AML were0%,34%(P<0.05). The positive rate of CD56in the group of the normal controls, NHAMLand HAML were0%,36.8%,26.7%, and statistic analysis showed no significantdifference among these groups (P>0.05). The positive rate of CD56in normalcontrols, the group without leukostasis and the group with leukostasis were0%,35.3%,37.5%, and statistic analysis showed no significant difference among thesegroups either (P>0.05).1.4CD11a1) The positive rate of CD11a in normal controls and the group of AML were80%,66%; Statistic analysis showed no obvious difference between the two groups(P>0.05). The positive rate of CD11a in the group of the normal controls, NHAMLand HAML were80%,65.8%,66.7%; Statistic analysis showed no obviousdifference among these groups (P>0.05). The positive rate of CD11a in normalcontrols, the group without leukostasis and the group with leukostasis were80%,64.7%,62.5%; Statistic analysis showed no obvious difference among these groupseither (P>0.05).2) The MFI of CD11a in the group of AML was83.68±74.76which was no obviousdifference compared with the normal controls (74.71±16.33, P>0.05). The MFI ofCD11a in the group of NHAML, HAML, the group without leukostasis and thegroup with leukostasis were74.86±68.33,106.01±87.61,63.33±54.64and110.87±92.01, respectively. Statistic analysis showed the CD11a expression in thegroup without leukostasis lower than that in normal controls (P<0.017), but there was no obvious difference between the group with leukostasis and the groupwithout leukostasis (P>0.017), No significant difference among the group ofnormal controls, NHAML and HAML either (P>0.05).2The incidence of leukostasis in the group of AML was19.0%, and the incidence ofleukostasis in HAML was83.3%, which was higher than NHAML (8.3%). Theincidence of leukostasis in AML-M4was50%, which is higher than AML-M2,unknown-type and the other types of AML (11.5%,22.2%,0%).3The early mortality in AML was4.8%. And the early mortality in HAML and in thegroup with leukostasis were33.3%,25%, respectively. Conversely, none patients inNHAML and the group without leukostasis died during the first week afterpermission (0%).The early mortality in AML-M4was16.7%, that is higher thanAML-M2and the other types of AML (3.8%,0%). Two patients died during the firstweek they have the same clinical information such as high level of white bloodcells and the clinical manifestation of leukostasis, moreover, they both express CD56in bone marrow mononuclear cell.Conclusion:1. The expression level of CD44in hyperleukocytic AML is higher than non-hyperleukocytic AML, and there was a positive correlation between the white bloodcell counts and the expression level of CD44in AML(r=0.446, P=0.001).2. The positive rate of CD56in AML was34%, but CD56is negative in normalcontrols, which indicate CD56is one of the immunophenotypes of AML. Twopatients, died during the first week after permission, both express CD56in bonemarrow mononuclear cell, CD56maybe one of the poor prognostic factors.3. The relationship of the leukostasis and the expression level of CD54, CD11a in AMLis still need to study.4. The incidence of leukostasis and the early mortality in hyperleukocytic AML ishigher than non-hyperleukocytic AML. 5. The results of this study have important clinical reference value, these theoriesdeserve further investigation. |
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