Prognosis of acute myeloid leukemia (AML) is dependent on patient specific characteristics and disease related factors. Estimation of prognosis, at initial diagnosis as well as in the course of the therapy, is used to guide treatment decisions.
Besides cytomorphology, cytogenetics and molecular genetics, flow cytometry (FCM) is an indispensable tool for the initial diagnosis of AML by quantitative and qualitative evaluation of antigen expression and represents an integral component of many scores to predict prognosis. Furthermore, FCM is increasingly used to monitor response to treatment.
In 80-94% of patients, immunophenotypical aberrancies (leukemia associated phenotype LAP) can be detected, which allows a clear distinction from non-malignant hematopoietic cells. The LAP can not only be used to detect, but also to quantify minimal residual disease (MRD). Persistence of MRD as detected by FCM has been shown to be associated with an increased risk of relapse. Clinical trials using MRD detected by FCM as a trigger to increase treatment intensity are ongoing.
We aim here at analyzing the expression of JAM-C, ESAM, JAM4 and JAML by flow cytometry of AML samples at initial diagnosis available in the AML registry. Their expression will be correlated with patient and disease characteristics and associated with outcome. In parallel, the expression will be correlated with response within an ongoing treatment optimization study. Additionally, we will identify patients with longitudinal available samples to quantify the persistence of AML blasts expressing these markers in the course of treatment. The MRD level will be correlated with relapse risk.
- Examine the expression of JAM-C, ESAM, JAM4 and JAML on AML blasts by flow cytometry to further refine individual prognosis at initial diagnosis.
- Explore these molecules as markers for treatment response and their value to detect MRD.