Expression of multiple leukemic stem cell markers is associated with poor prognosis in de novo acute myeloid leukemia

Abstract

Leukemic stem cells (LSCs) play a crucial role in chemotherapy resistance in acute myeloid leukemia (AML). Although the association between the expression of individual LSC markers and poor prognosis has been reported, few studies have evaluated the prognostic effect of multiple LSC markers in patients with AML. Herein, we examined three LSC markers (CD25, CD96, and CD123) and the combined effect of their expression on clinical outcome. We retrospectively analyzed 80 adult patients with de novo AML who received intensive chemotherapy. Multiple LSC marker expression was significantly associated with shorter three-year overall survival (OS), compared with single or no LSC marker expression (18.2 vs. 65.0%, p < .001). Multivariate analysis showed that the expression of multiple LSC markers remained significant in terms of three-year OS (hazard ratio: 3.80, p = .001). Therefore, the combined evaluation of several LSC markers can predict the clinical outcome in patients with AML.

Key Words:

• Acute myeloid leukemia
• leukemic stem cell
• immunophenotypic studies

Acknowledgements

We thank Mr. Kaoru Sueoka, Mr. Masahiro Yoshida, Ms. Yukiko Yano, Ms. Eiko Yamashita, Mr. Kazuyuki Ueno, and Ms. Kyoko Tanaka from the Department of Clinical Laboratory, Kobe City Medical Center General Hospital for their technical assistance. Part of this work was presented at the 22nd Congress of the European Hematology Association, Madrid, Spain, June 22–25, 2017.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2017.1410888.