成人急性骨髄性白血病の予後におけるCD7陽性の意義  [in Japanese] Prognostic Significance of CD7 Expression in Adult Acute Myeloid Leukemia  [in Japanese]

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Author(s)

    • 斎藤 健 SAITO Takeshi
    • 東京慈恵会医科大学内科学講座第三 Department of Internal Medicine (III), Jikei University School of Medicine
    • 薄井 紀子 USUI Noriko
    • 東京慈恵会医科大学内科学講座第三 Department of Internal Medicine (III), Jikei University School of Medicine
    • 牧 信子 MAKI Nobuko
    • 東京慈恵会医科大学内科学講座第三 Department of Internal Medicine (III), Jikei University School of Medicine
    • 浅井 治 ASAI Osamu
    • 東京慈恵会医科大学内科学講座第三 Department of Internal Medicine (III), Jikei University School of Medicine
    • 矢野 真吾 YANO Shingo
    • 東京慈恵会医科大学内科学講座第三 Department of Internal Medicine (III), Jikei University School of Medicine
    • 加藤 明徳 KATO Akinori
    • 東京慈恵会医科大学内科学講座第三 Department of Internal Medicine (III), Jikei University School of Medicine
    • 渡辺 浩 WATANABE Hiroshi
    • 東京慈恵会医科大学内科学講座第三 Department of Internal Medicine (III), Jikei University School of Medicine
    • 長峰 守 NAGAMINE Mamoru
    • 東京慈恵会医科大学内科学講座第三 Department of Internal Medicine (III), Jikei University School of Medicine
    • 荻原 朝彦 OGIHARA Asahiko
    • 東京慈恵会医科大学内科学講座第三 Department of Internal Medicine (III), Jikei University School of Medicine
    • 小林 直 KOBAYASHI Tadashi
    • 東京慈恵会医科大学内科学講座第三 Department of Internal Medicine (III), Jikei University School of Medicine
    • 田嶋 尚子 TAJIMA Naoko
    • 東京慈恵会医科大学内科学講座第三 Department of Internal Medicine (III), Jikei University School of Medicine

Abstract

成人急性骨髄性白血病(AML)においてCD7が予後因子となり得るかを評価する目的で,CD7陽性(+) AMLとCD7陰性(-) AMLの治療成績の比較検討を行いその意義について検討した。対象症例は1989年9月より1996年1月までの6年4カ月の間に,当科に入院した15∼65歳の<i>de novo</i> AML症例63例である。63例中表面マーカー検索材料中の芽球が70%以下の9例,早期死亡例(1カ月以内)2例を除外した52例が評価可能症例であった。FAB分類ではM1: 10例,M2: 16例,M3: 11例,M4: 8例,M5: 5例,M6: 2例であった。評価可能症例中CD7+AML症例は10例で,FAB分類ではM1: 3例,M2: 6例,M3: 1例であった。CD7-症例42例中CRは33例(CR率:78.6%),無再発生存率は22.1%, 4年生存率は35.4%であったのに対し,CD7+例10例のCR率は60%(6例),無再発生存率は53.3%, 4年生存率は44.4%であった。CD7+AMLとCD7-AMLの間で性別,血液学的所見,肝脾腫,リンパ節腫大,中枢神経系浸潤の有無,CR率,4年無再発生存率に有意差を認めなかった。CD7陽性は単独では予後因子となり得ないと考えられた。

To evaluate the prognostic significance of CD7 expression in <i>de novo</i> acute myeloid leukemia (AML), we studied 63 patients with AML who had been admitted to our hospital between September 1989 and January 1996. Eleven of the patients were later eliminated from the study (9 due to insufficient surface marker analyses, and 2 due to early death). The remaining 52 patients (median age: 42.5 years) were evaluated for morphologic subtype, immunophenotypic classification, complete remission (CR), diseasefree survival (DFS) and overall survival (OS). All 52 patients were grouped by the French-American-British classification system: 10 as M1, 16 as M2, 11 as M3, 8 as M4, 5 as M5, and 2 as M6. Ten of the patients expressed CD7 on their leukemic cells (positive rate ≥25) and were classified as CD7 (+) AML, with morphological subtypes as follows: 3 as M1, 6 as M2, and 1 as M3. Thirty-three of the 42 patients with CD7-AML (78.6%) and 6 of the 10 patients with CD7+AML (40%) achieved CR. DFS and OS rates for the patients with CD7 (-) AML were 22.1% and 35.4%, respectively; those for the CD7 (+) AML patients were 53.3% and 44.4%, respectively. No significant differences in gender, hematological findings, clinical manifestations such as hepatosplenomegaly, lymphadenopathy, or incidence of cemtral nervous system involvement, CR rate, and DFS distinguished patients with CD7 (+) AML from those with CD7 (-) AML. These results suggest that CD7 expression is unlikely to be a prognostic factor in AML.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 39(7), 481-486, 1998-07-30

    The Japanese Society of Hematology

References:  17

Cited by:  2

Codes

  • NII Article ID (NAID)
    10006173642
  • NII NACSIS-CAT ID (NCID)
    AN00252940
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    04851439
  • NDL Article ID
    4528760
  • NDL Source Classification
    ZS21(科学技術--医学--内科学)
  • NDL Call No.
    Z19-295
  • Data Source
    CJP  CJPref  NDL  J-STAGE 
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