Prognostic Value of Immunophenotyping in Acute Myeloid Leukemia

The diagnostic and prognostic value of immunophenotyping with 18 murine monoclonal antibodies (MoAbs) t o a variety of leukocyte differentiation antigens was assessed in 168 adults aged 15 to 60 years with acute myeloid leukemia (AML). Patients were entered on the multicentre Australian Leukaemia Study Group M4 protocol, and were randomized t o receive either standard or high-dose Ara-C together with daunorubicin and etoposide as induction chemotherapy, followed by standard consolidation and maintenance therapy. Diagnostic bone marrow aspirate (152 cases) or peripheral blood samples (16) were analyzed by indirect immunofluorescence and flow cytometry. MoAbs used were directed at myeloid (CDllb, CD13, CD14, CD15, CD33, CD41). lymphoid (CD2, CD3. CD7, CD9, CD10. CD19). or stem cell (HLA-DR, CD34, c-kit receptor) antigens, as well as the leukocyte integrins CD18 and CD49e, and the transferrin receptor CD71. Of the myeloid markers, CD13 and CD33 were the most useful diagnostically (71% and 79% of cases positive, respectively), with CDllb, CD14, and CD15 less commonly positive. A mi-