Skip to main content
SpringerLink
Log in

Prognostic value of lymphoid marker CD7 expression in acute myeloid leukemia patients undergoing allogeneic hematopoietic cell transplantation in first morphological complete remission

  • Original Article
  • Published:
International Journal of Hematology Aims and scope Submit manuscript

Abstract

Although defined as a lymphoid surface marker, CD7 is aberrantly expressed on a subtype of acute myeloid leukemia cells and appears to be associated with an inferior response to chemotherapy. Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative modality but no data has been reported in CD7-positive AML patients. We performed a retrospective analysis involving 141 AML patients who underwent allo-HCT in first morphological complete remission (CR1). The results showed that CD7-positive AML patients had a poor 2-year overall survival (64.5% vs 82.0%, P = 0.040), relapse-free survival (RFS) (56.5% vs 79.4%, P = 0.005), and higher cumulative incidence of relapse (27.0% vs 9.7%, P = 0.003) post-HCT. In addition, expression of CD7 was related to RAS and RUNX1 mutation, and high residual disease level pre-HCT. Multivariate analyses showed CD7 expression at diagnosis was an independent risk factor for RFS (P = 0.016, HR = 0.418) and relapse (P = 0.014, HR = 0.307). We concluded that for AML patients in CR1, CD7 is a negative predictor for allo-transplant outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Lewis RE, Cruse JM, Sanders CM, Webb RN, Suggs JL. Aberrant expression of T-cell markers in acute myeloid leukemia. Exp Mol Pathol. 2007;83:462–3.

    Article  CAS  PubMed  Google Scholar 

  2. Ochi K, Fuji S, Takano K, Tajima K, Ito A, Tanaka T, et al. The putative anti-leukemic effects of anti-thymocyte globulins in patients with CD7-positive acute myeloid leukemia. Bone Marrow Transplant. 2018;53:1019–29.

    Article  CAS  PubMed  Google Scholar 

  3. Tien HF, Chou CC, Wang CH, Chang CH, Hsing CC. Putative normal counterparts of leukaemic cells from CD7-positive acute myeloid leukaemia can be demonstrated in human haemopoietic tissues. Br J Haematol. 1996;94:501–6.

    CAS  PubMed  Google Scholar 

  4. Chang H, Yeung J, Brandwein J, Yi QL. CD7 expression predicts poor disease free survival and post-remission survival in patients with acute myeloid leukemia and normal karyotype. Leuk Res. 2007;31:157–62.

    Article  CAS  PubMed  Google Scholar 

  5. Kita K, Miwa H, Nakase K, Kawakami K, Kobayashi T, Shirakawa S, et al. Clinical importance of CD7 expression in acute myelocytic leukemia. The Japan Cooperative Group of Leukemia/Lymphoma. Blood. 1993;81:2399–405.

    Article  CAS  PubMed  Google Scholar 

  6. Saxena A, Sheridan DP, Card RT, McPeek AM, Mewdell CC, Skinnider LF. Biological and clinical significance of CD7 expression in acute myeloid leukemia. Am J Hematol. 1998;58:278–84.

    Article  CAS  PubMed  Google Scholar 

  7. Rai S, Singh S, Gupta R. Prognostic significance of CD56 and CD7 in acute myeloid leukaemia and their outcome. Am J Blood Res. 2020;10:109–17.

    PubMed  PubMed Central  Google Scholar 

  8. Ogata K, Yokose N, Shioi Y, Ishida Y, Tomiyama J, Hamaguchi H, et al. Reappraisal of the clinical significance of CD7 expression in association with cytogenetics in de novo acute myeloid leukaemia. Br J Haematol. 2001;115:612–5.

    Article  CAS  PubMed  Google Scholar 

  9. Del Poeta G, Stasi R, Venditti A, Cox C, Aronica G, Masi M, et al. CD7 expression in acute myeloid leukemia. Leuk Lymphoma. 1995;17:111–9.

    Article  PubMed  Google Scholar 

  10. Döhner H, Estey E, Grimwade D, Amadori S, Appelbaum FR, Büchner T, et al. Diagnosis and management of AML in adults: 2017 ELN recommendations from an International Expert Panel. Blood. 2017;129:424–47.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Chen J, Yang L, Fan Y, Xu Y, Han Y, Tang X, et al. Comparison of autologous stem cell transplantation versus haploidentical donor stem cell transplantation for favorable- and intermediate-risk acute myeloid leukemia patients in first complete remission. Biol Blood Marrow Transplant. 2018;24:779–88.

    Article  PubMed  Google Scholar 

  12. Wang H, Chu TT, Han SY, Qi JQ, Tang YQ, Qiu HY, et al. FLT3-ITD and CEBPA mutations predict prognosis in acute myelogenous leukemia irrespective of hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2019;25:941–8.

    Article  CAS  PubMed  Google Scholar 

  13. Wan L, Xu M, Chen J, Yang Z, Xu M, Shen H, et al. Pretransplant FLT3-ITD levels predict outcome after allogeneic hematopoietic cell transplantation for AML patients in the first remission. Bone Marrow Transplant. 2020;55:821–3.

    Article  PubMed  Google Scholar 

  14. Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J, et al. 1994 consensus conference on acute GVHD grading. Bone Marrow Transplant. 1995;15:825–8.

    CAS  PubMed  Google Scholar 

  15. Filipovich AH, Weisdorf D, Pavletic S, Socie G, Wingard JR, Lee SJ, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant. 2005;11:945–56.

    Article  PubMed  Google Scholar 

  16. Perea G, Lasa A, Aventín A, Domingo A, Villamor N, de Llano MPQ, et al. Prognostic value of minimal residual disease (MRD) in acute myeloid leukemia (AML) with favorable cytogenetics [t (8;21) and inv (16)]. Leukemia. 2006;20:87–94.

    Article  CAS  PubMed  Google Scholar 

  17. Tian H, Chen GH, Xu Y, Ma X, Chen F, Yang Z, et al. Impact of pre-transplant disease burden on the outcome of allogeneic hematopoietic stem cell transplant in refractory and relapsed acute myeloid leukemia: a single-center study. Leuk Lymphoma. 2015;56:1353–61.

    Article  CAS  PubMed  Google Scholar 

  18. Zhao XS, Yan CH, Liu DH, Xu LP, Liu YR, Liu KY, et al. Combined use of WT1 and flow cytometry monitoring can promote sensitivity of predicting relapse after allogeneic HSCT without affecting specificity. Ann Hematol. 2013;92:1111–9.

    Article  CAS  PubMed  Google Scholar 

  19. Tang S, Shen H, Mao X, Dai H, Zhu X, Xue S, et al. FLT3-ITD with DNMT3A R882 double mutation is a poor prognostic factor in Chinese patients with acute myeloid leukemia after chemotherapy or allogeneic hematopoietic stem cell transplantation. Int J Hematol. 2017;106:552–61.

    Article  CAS  PubMed  Google Scholar 

  20. Murphy KM, Levis M, Hafez MJ, Geiger T, Cooper LC, Smith BD, et al. Detection of FLT3 internal tandem duplication and D835 mutations by a multiplex polymerase chain reaction and capillary electrophoresis assay. J Mol Diagn. 2003;5:96–102.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Shan M, Lu Y, Yang M, Wang P, Lu S, Zhang L, et al. Characteristics and transplant outcome of myeloid sarcoma: a single-institute study. Int J Hematol. 2021;113:682–92.

    Article  PubMed  Google Scholar 

  22. Simon R, Makuch RW. A non-parametric graphical representation of the relationship between survival and the occurrence of an event: application to responder versus non-responder bias. Stat Med. 1984;3:35–44.

    Article  CAS  PubMed  Google Scholar 

  23. Mantel N, Byar DP. Evaluation of response-time data involving transient states: an illustration using heart-transplant data. Am Stat Assoc. 1974;69:81–6.

    Article  Google Scholar 

  24. Bárcena A, Muench MO, Roncarolo MG, Spits H. Tracing the expression of CD7 and other antigens during T- and myeloid-cell differentiation in the human fetal liver and thymus. Leuk Lymphoma. 1995;17:1–11.

    Article  PubMed  Google Scholar 

  25. Sempowski GD, Lee DM, Kaufman RE, Haynes BF. Structure and function of the CD7 molecule. Crit Rev Immunol. 1999;19:331–48.

    CAS  PubMed  Google Scholar 

  26. Cruse JM, Lewis RE, Pierce S, Lam J, Tadros Y. Aberrant expression of CD7, CD56, and CD79a antigens in acute myeloid leukemias. Exp Mol Pathol. 2005;79:39–41.

    Article  CAS  PubMed  Google Scholar 

  27. Baqai J, Crisan D. Correlation of FLT3 mutations with expression of CD7 in acute myeloid leukemia. Appl Immunohistochem Mol Morphol. 2015;23:104–8.

    Article  CAS  PubMed  Google Scholar 

  28. Levis MJ, Perl AE, Altman JK, Gocke CD, Bahceci E, Hill J, et al. A next-generation sequencing–based assay for minimal residual disease assessment in AML patients with FLT3-ITD mutations. Blood Adv. 2018;2:825–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Gale RE, Hills R, Kottaridis PD, Srirangan S, Wheatley K, Burnett AK, et al. No evidence that FLT3 status should be considered as an indicator for transplantation in acute myeloid leukemia (AML): an analysis of 1135 patients, excluding acute promyelocytic leukemia, from the UK MRC AML 10 and 12 trials. Blood. 2005;106:3658–65.

    Article  CAS  PubMed  Google Scholar 

  30. Gaidzik VI, Bullinger L, Schlenk RF, Zimmermann AS, Röck J, Paschka P, et al. RUNX1 mutations in acute myeloid leukemia: results from a comprehensive genetic and clinical analysis from the AML study group. J Clin Oncol. 2011;29:1364–72.

    Article  PubMed  Google Scholar 

  31. Tang JL, Hou HA, Chen CY, Liu CY, Chou WC, Tseng MH, et al. AML1/RUNX1 mutations in 470 adult patients with de novo acute myeloid leukemia: prognostic implication and interaction with other gene alterations. Blood. 2009;114:5352–61.

    Article  CAS  PubMed  Google Scholar 

  32. Chou SC, Tang JL, Hou HA, Chou WC, Hu HC, Chen CY, et al. Prognostic implication of gene mutations on overall survival in the adult acute myeloid leukemia patients receiving or not receiving allogeneic hematopoietic stem cell transplantations. Leuk Res. 2014;38:1278–84.

    Article  CAS  PubMed  Google Scholar 

  33. Porwit A, Bene MC. Acute leukemias of ambiguous origin. Am J Clin Pathol. 2015;144:361–76.

    Article  CAS  PubMed  Google Scholar 

  34. Poopak B, Khosravi A, Bahoush-Mehdiabadi G, Madani T, Khodadi E, Farahani Z, et al. Mixed-phenotype acute leukemia characteristics: first report from Iran. Clin Exp Med. 2018;18:513–21.

    Article  CAS  PubMed  Google Scholar 

  35. Cross AH, Goorha RM, Nuss R, Behm FG, Murphy SB, Kalwinsky DK, et al. Acute myeloid leukemia with T-lymphoid features: a distinct biologic and clinical entity. Blood. 1988;72:579–87.

    Article  CAS  PubMed  Google Scholar 

  36. Gomes-Silva D, Atilla E, Atilla PA, Mo FY, Tashiro H, Srinivasan M, et al. CD7 CAR T cells for the therapy of acute myeloid leukemia. Mol Ther. 2019;27:272–80.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work is strongly supported by the National Natural Science Foundation of China (81873432, 81730003, 81700173, 81670132, 81500146), National Science and Technology Major Project (2017ZX09304021), National Key R&D Program of China (2019YFC0840604, 2017YFA0104502, 2017YFA0104500), grants from the Jiangsu Province of China (ZDRCA2016047), Key R&D Program of Jiangsu Province (BE2019798), Jiangsu Natural Science Foundation (BK20150356), Natural Science Foundation of the Jiangsu Higher Education Institution of China (18KJA320006), Jiangsu Medical Outstanding Talents Project (JCRCA2016002), Jiangsu Provincial Key Medical Center (YXZXA2016002), Translational Research Grant of NCRCH (2020WSC05), and Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD).

Author information

Author notes

  1. Kangkang Lv, Chengsen Cai, and Jia Chen are co-first authors.

Authors and Affiliations

  1. National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, 215006, China

    Kangkang Lv, Chengsen Cai, Jia Chen, Mimi Xu, Li Wan, Meng Zhou, Yuanyuan Du, Xiao Ma, Xiaojin Wu, Xiaowen Tang, Huiying Qiu, Depei Wu, Yue Han & Yuejun Liu

  2. Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China

    Kangkang Lv, Chengsen Cai, Jia Chen, Mimi Xu, Li Wan, Meng Zhou, Yuanyuan Du, Xiao Ma, Xiaojin Wu, Xiaowen Tang, Huiying Qiu, Depei Wu, Yue Han & Yuejun Liu

Authors
  1. Kangkang Lv
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chengsen Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jia Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mimi Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Li Wan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Meng Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yuanyuan Du
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Xiao Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Xiaojin Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Xiaowen Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Huiying Qiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Depei Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Yue Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Yuejun Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Yue Han or Yuejun Liu.

Ethics declarations

Conflict of interest

No conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 327 KB)

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lv, K., Cai, C., Chen, J. et al. Prognostic value of lymphoid marker CD7 expression in acute myeloid leukemia patients undergoing allogeneic hematopoietic cell transplantation in first morphological complete remission. Int J Hematol 114, 464–471 (2021). https://doi.org/10.1007/s12185-021-03182-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12185-021-03182-y

Keywords

Search

Navigation