Quantitative analyses of CD7, CD33, CD34, CD56, and CD123 within the FLT3-ITD/NPM1-MUT myeloblastic/monocytic bulk AML blastic populations

Abstract

The most frequent mutations in acute myeloid leukemia (AML) – FLT3-ITD and NPM1 – are associated with a specific immunophenotype. We evaluated the levels of surface antigens in an uninvestigated AML patient population according to the combination of FLT3-ITD/NPM1 mutations. Antigen levels were calculated as the geometric mean fluorescence index (MFI) ratio between myeloblasts or monoblasts/monocytes and a negative population for the specific antigen. In myeloblastic populations, FLT3-ITD cases presented CD7^high MFI values (p < .001), while NPM1-MUT cases presented CD33^high (p < .001), and CD34^low (p < .001) MFI values. Within the monoblastic/monocytic populations, CD56^high expression was observed only in the FLT3-WT/NPM1-MUT population (p=.003). The single common antigen expression between myeloblasts and monoblasts/monocytes was CD123^high expression only within the FLT3-ITD/NPM1-MUT subgroup. Our results present a subtle influence of FLT3-ITD/NPM1 mutations upon antigen expression profiles in myeloblasts vs monoblasts/monocytes, and we described a novel correlation between the presence of NPM1 and CD56^high values within bulk leukemic monoblasts/monocytes.

Keywords:

• AML
• FLT3-ITD
• NPM1
• MFI

Acknowledgments

We would like to express our gratitude to all physicians who referred samples to our center, and our nursing staff for organizing, processing, and handling patient samples.

Disclosure statement

The authors have no conflicts of interest to declare.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This study was funded through the RO19.10 Project, funders – Norway Grants & the Romanian Government, and the Acute leukemia diagnostic subprogram, funder – the Romanian National Health Insurance House.