Korean J Lab Med.  2007 Oct;27(5):313-317. 10.3343/kjlm.2007.27.5.313.

Characteristics of Acute Myeloid Leukemia without HLA-DR Expression

• Moon H
• Lee S
• Huh J
• Chung WS

• KMID: 1781528
• DOI: http://doi.org/10.3343/kjlm.2007.27.5.313

Abstract

BACKGROUND: HLA-DR negativity is known to be useful for distinguishing acute promyelocytic leukemia (APL) from other subtypes of AML, but non-APL cases without HLA-DR antigen expression have been reported. The purpose of this study was to evaluate and compare the characteristics of APL, HLA-DR negative non-APL, and HLA-DR positive non-APL cases. METHODS: A total of 114 cases of AML admitted at Ewha Womans University, Mokdong Hospital between March 1997 and June 2006 were included in this study. A diagnosis of AML was made based on the results of morphology, cytochemistry, immunophenotype, cytogenetics, and/or fluorescence in situ hybridization. RESULTS: Among the 114 AML patients, HLA-DR antigen was not expressed in 39 (34%), including 24 non-APL (62%) and 15 APL patients (38%). The HLA-DR negative non-APL group showed higher leukocyte counts and positive rate of CD19 expression than did APL group (P<0.05). The remaining laboratory findings were not statistically different between the HLA-DR negative non-APL and APL groups. CD34 expression was more frequent in the HLA-DR positive non-APL group than in the HLA-DR negative non-APL group and APL group. Of the 24 patients with HLA-DR negative non-APL, 7 patients had disseminated intravascular coagulation and 2 patients showed morphologic features similar to those of APL. CONCLUSIONS: CD19 expression and leukocyte count may be helpful for differentiating HLA-DR negative non-APL from APL. However, the final diagnosis and classification should be confirmed by cytogenetic or molecular studies.

Keyword

HLA-DR negative; Immunophenotype; AML; Acute promyelocytic leukemia

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Antigens, CD19/metabolism
Antigens, CD34/metabolism
Child
Child, Preschool
Female
HLA-DR Antigens/*metabolism
Humans
Immunophenotyping
Leukemia, Myeloid, Acute/*diagnosis/pathology
Leukocyte Count
Male
Middle Aged
Retrospective Studies

Figure

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  Fig. 1. A case of 21 yr-old female patient diagnosed as HLA-DR negative AML. Immature cells showed indented nuclear margins and coarse cytoplasmic granules (BM aspiration, Wright stain, ×1,000).

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