RT Journal Article
T1 Basophil-lineage commitment in acute promyelocytic leukemia predicts for severe bleeding after starting therapy.
A1 Matarraz, Sergio
A1 Leoz, Pilar
A1 Fernández, Carlos
A1 Colado, Enrique
A1 Chillón, María Carmen
A1 Vidriales, María Belén
A1 González, Marcos
A1 Rivera, Daniel
A1 Osuna, Carlos Salvador
A1 Caballero-Velázquez, Teresa
A1 Van Der Velden, Vincent
A1 Jongen-Lavrencic, Mojca
A1 Gutiérrez, Oliver
A1 Bermejo, Ana Yeguas
A1 Alonso, Luis García
A1 García, Monique Bourgeois
A1 De Ramón Sánchez, Cristina
A1 García-Donas, Gloria
A1 Mateo, Aránzazu García
A1 Recio, Isabel
A1 Sánchez-Real, Javier
A1 Mayado, Andrea
A1 Gutiérrez, María Laura
A1 Bárcena, Paloma
A1 Barrena, Susana
A1 López, Antonio
A1 Van Dongen, Jacques
A1 Orfao, Alberto
AB Severe hemorrhagic events occur in a significant fraction of acute promyelocytic leukemia patients, either at presentation and/or early after starting therapy, leading to treatment failure and early deaths. However, identification of independent predictors for high-risk of severe bleeding at diagnosis, remains a challenge. Here, we investigated the immunophenotype of bone marrow leukemic cells from 109 newly diagnosed acute promyelocytic leukemia patients, particularly focusing on the identification of basophil-related features, and their potential association with severe bleeding episodes and patient overall survival.From all phenotypes investigated on leukemic cells, expression of the CD203c and/or CD22 basophil-associated markers showed the strongest association with the occurrence and severity of bleeding (p ≤ 0.007); moreover, aberrant expression of CD7, coexpression of CD34+/CD7+ and lack of CD71 was also more frequently found among patients with (mild and severe) bleeding at baseline and/or after starting treatment (p ≤ 0.009). Multivariate analysis showed that CD203c expression (hazard ratio: 26.4; p = 0.003) and older age (hazard ratio: 5.4; p = 0.03) were the best independent predictors for cumulative incidence of severe bleeding after starting therapy. In addition, CD203c expression on leukemic cells (hazard ratio: 4.4; p = 0.01), low fibrinogen levels (hazard ratio: 8.8; p = 0.001), older age (hazard ratio: 9.0; p = 0.002), and high leukocyte count (hazard ratio: 5.6; p = 0.02) were the most informative independent predictors for overall survival.In summary, our results show that the presence of basophil-associated phenotypic characteristics on leukemic cells from acute promyelocytic leukemia patients at diagnosis is a powerful independent predictor for severe bleeding and overall survival, which might contribute in the future to (early) risk-adapted therapy decisions.
YR 2018
FD 2018-03-23
LK http://hdl.handle.net/10668/12271
UL http://hdl.handle.net/10668/12271
LA en
DS RISalud
RD Apr 7, 2025