lewis-x-antigen and Leukemia--Myeloid

Topics: Animals; Antibodies, Monoclonal; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Humans; Leukemia, Myeloid; Lewis X Antigen; Lipopolysaccharide Receptors; Mice; Radioimmunotherapy; Sialic Acid Binding Ig-like Lectin 3

Several studies have shown survival benefit by autologous stem cell transplantation in acute myeloid leukemia (AML) after purging of grafts. This has, however, not been confirmed in randomized studies due to high toxicity of purging modalities for normal progenitor/stem cells. In this study, we investigated whether positive selection for CD34+ and/or CD133+ cells, which results in high recovery of normal progenitor/stem cells, is applicable for purging AML grafts.. Positive selections of normal stem cells using CD34 and/or CD133 can be done if one or both markers are absent or have dim expression and remain so during the course of the disease. Marker expressions in newly diagnosed AML were measured with flow cytometry using a cutoff value for positivity of 1%. Stability of marker expression was studied by pairwise comparison of material at diagnosis and relapse. Leukemia associated phenotype expression was used to measure the efficacy of tumor cell reduction.. In newly diagnosed AML (n = 165), we found no CD34 and/or CD133 expression in 32% of the cases and dim expression in 20% of the cases. No increase in the percentage of CD34+ cells (n = 44) and CD133+ cells (n = 29) was found in corresponding relapses. Positive selection using grafts contaminated with AML blasts, showing either no or dim expression of CD34 or CD133, resulted in a 3 to 4 log tumor cell reduction (n = 11) with median 50% recovery of normal stem cells.. Purging by positive selection of CD34+ and/or CD133+ cells can safely, effectively, and reproducibly be applied in about 50% of AML cases.

Topics: AC133 Antigen; Acute Disease; Antigens, CD; Antigens, CD34; Bone Marrow Purging; Female; Glycoproteins; Hematopoietic Stem Cells; Humans; Leukemia, Myeloid; Leukocyte Common Antigens; Lewis X Antigen; Male; Peptides; Peripheral Blood Stem Cell Transplantation; Treatment Outcome

Sixteen patients with acute myeloid leukemia (AML) were treated with a continuous i.v. infusion of mAb PM-81, an IgM mAb directed against the cellular differentiation antigen CD15, which is expressed on leukemia cells of >95% of patients with AML. MAb PM-81, also referred to as MDX-11, is capable of activating human and rabbit complement and lysing CD15-positive AML cells. In this Phase I study, patients were treated with 0.5, 1.0, or 1.5 mg/kg MDX-11 delivered over a 24-h period followed by conventional chemotherapy. Transient decreases in circulating blast cells postinfusion (prior to chemotherapy) were observed at all doses. We were able to show MDX-11 binding to bone marrow blasts in those patients who achieved stable serum levels of MDX-11. Serum MDX-11 was detectable at the 1. 0- and 1.5-mg/kg doses. Doses of 0.5 and 1.0 mg/kg were generally well tolerated, with no toxicities greater than grade II (Eastern Cooperative Oncology Group) reported. However, two of five patients receiving the 1.5-mg/kg dose experienced grade IV toxicities that resolved with treatment (one of these patients completed the infusion). Common toxicities reported included fever, chills, and hypotension. Only one patient developed human antimouse antibodies at 4 weeks posttreatment. This study determined that 1.0 mg/kg is a biologically effective dose that can be administered safely with little toxicity. Based on these results, we are pursuing a Phase I/II study of MDX-11 infusion following chemotherapy for patients with relapsed AML.

Topics: Acute Disease; Adult; Aged; Antibodies, Monoclonal; Feasibility Studies; Female; HL-60 Cells; Humans; Immunoglobulin M; Leukemia, Myeloid; Leukocyte Count; Lewis X Antigen; Male; Middle Aged

Polysomy 8 is a rare abnormality, one that has been reported as associated with secondary evolution, monocytic differentiation, or poor prognosis in myeloid neoplasm. In contrast to tetrasomy 8, which is most commonly observed, pentasomy 8 is a minority component of polysomy 8. To date, only three cases of pentasomy 8 accompanied with 11q23 rearrangement have been reported. Reported here is a novel case of pentasomy 8 with partial tandem duplication of 11q23 in de novo acute myeloid leukemia. The findings contribute to understanding of the relation between the two abnormalities, which have their own individual leukemogenic potencies.

Topics: Acute Disease; Aged; Antigens, CD; Antigens, CD34; Antigens, Differentiation, Myelomonocytic; Bone Marrow Cells; CD13 Antigens; Chromosome Aberrations; Chromosome Banding; Chromosomes, Human, Pair 11; Chromosomes, Human, Pair 8; Gene Duplication; HLA-DR Antigens; Humans; In Situ Hybridization, Fluorescence; Karyotyping; Leukemia, Myeloid; Lewis X Antigen; Male; Proto-Oncogene Proteins c-kit; Sialic Acid Binding Ig-like Lectin 3

Leukostasis and tissue infiltration by leukemic cells are poorly understood life-threatening complications of acute leukemia. This study has tested the hypothesis that adhesion receptors and cytokines secreted by blast cells play central roles in these reactions. Immunophenotypic studies showed that acute myeloid leukemia (AML) cells (n = 78) of the M0 to M5 subtypes of the French-American-British Cooperative Group expressed various amounts of adhesion receptors, including CD11a, b, c/CD18, CD49d, e, f/CD29, CD54, sCD15, and L-selectin. The presence of functional adhesion receptors was evaluated using a nonstatic adhesion assay. The number of blast cells attached to unactivated endothelium increased by 7 to 31 times after a 6-hour exposure of endothelium to tumor necrosis factor (TNF)-alpha. Inhibition studies showed that multiple adhesion receptors--including L-selectin, E-selectin, VCAM-1, and CD11/CD18--were involved in blast cell adhesion to TNF-alpha-activated endothelium. Leukemic cells were then cocultured at 37 degrees C on unactivated endothelial cell monolayers for time periods up to 24 hours. A time-dependent increase in the number of blasts attached to the endothelium and a concomitant induction of ICAM-1, VCAM-1, and E-selectin were observed. Additional experiments revealed that endothelial cell activation by leukemic myeloblasts was caused by cytokine secretion by blast cells, in particular TNF-alpha and IL-1 beta, and direct contacts between adhesion receptors expressed by blast cells and endothelial cells. Thus, leukemic cells have the ability to generate conditions that promote their own adhesion to vascular endothelium, a property that may have important implications for the pathophysiology of leukostasis and tissue infiltration by leukemic blast cells. (Blood. 2001;97:2121-2129)

Topics: Antigens, CD; CD18 Antigens; Cell Adhesion; Cell Adhesion Molecules; Cells, Cultured; Coculture Techniques; E-Selectin; Endothelium, Vascular; Gene Expression Regulation, Leukemic; Humans; Integrin alpha4; Integrin alpha5; Integrin alpha6; Integrin alphaXbeta2; Integrin beta1; Intercellular Adhesion Molecule-1; Interleukin-1; L-Selectin; Leukemia, Myeloid; Leukemic Infiltration; Leukostasis; Lewis X Antigen; Lymphocyte Function-Associated Antigen-1; Macrophage-1 Antigen; Neoplasm Proteins; Neoplastic Stem Cells; Receptors, Lymphocyte Homing; Tumor Cells, Cultured; Tumor Necrosis Factor-alpha; Vascular Cell Adhesion Molecule-1

There is little information available regarding immunophenotypic monitoring of minimal residual disease (MRD) in acute myeloid leukaemia (AML). We investigated leukaemic cells co-expressing CD15 and CD117 (CD15+CD117+) in 72 adult AML cases at diagnosis. In 22 cases (31%) with various AML subtypes, more than 5% of leukaemic cells showed the CD15+CD117+ phenotype (range 5.22-55.48%). These 22 cases were younger and had a higher complete remission (CR) rate than the other AML cases, but the CD15+CD117+ cell percentage at diagnosis showed no correlation with the CR duration among the 72 cases. The CD15+CD117+ cell percentage showed a range of 0.00-0.08% in bone marrow cells from 10 haematologically normal subjects. We also investigated CD15+CD117+ cells in sequential bone marrow samples from 17 AML patients who achieved CR and who had had more than 5% CD15+CD117+ leukaemic cells at diagnosis. Because the CD15+CD117+ cell percentage varied among these AML cases, we calculated the percentage of MRD ¿MRD% = [CD15+CD117+ cells (%) in each sequential marrow sample] / [CD15+CD117+ cells (%) at diagnosis of the corresponding case] x 100¿. A high MRD% after 10 months of CR was significantly associated with a short CR duration (P = 0.0004), whereas continuation of a well-reduced MRD% was associated with a long CR duration. The leukaemic cells conserved the CD15+CD117+ phenotype in all of the eight cases who relapsed. Flow cytometric monitoring of CD15+CD117+ cells is simple and can be applied to a substantial fraction of AML cases. This monitoring may be useful for predicting relapse of adult AML.

Topics: Adult; Aged; Bone Marrow Cells; Case-Control Studies; Female; Flow Cytometry; Humans; Leukemia, Myeloid; Lewis X Antigen; Male; Middle Aged; Neoplasm, Residual; Proto-Oncogene Proteins c-kit; Recurrence

Blockage in myeloid differentiation characterizes acute myeloid leukemia (AML); the stage of the blockage defines distinct AML subtypes (AML1/2 to AML5). Differentiation therapy in AML has recently raised interest because the survival of AML3 patients has been greatly improved using the differentiating agent retinoic acid. However, this molecule is ineffective in other AML subtypes. The CD44 surface antigen, on leukemic blasts from most AML patients, is involved in myeloid differentiation. Here, we report that ligation of CD44 with specific anti-CD44 monoclonal antibodies or with hyaluronan, its natural ligand, can reverse myeloid differentiation blockage in AML1/2 to AML5 subtypes. The differentiation of AML blasts was evidenced by the ability to produce oxidative bursts, the expression of lineage antigens and cytological modifications, all specific to normal differentiated myeloid cells. These results indicate new possibilities for the development of CD44-targeted differentiation therapy in the AML1/2 to AML5 subtypes.

Topics: Acute Disease; Antibodies, Monoclonal; Bone Marrow; Cell Differentiation; Dose-Response Relationship, Drug; Granulocyte Colony-Stimulating Factor; Granulocytes; Humans; Hyaluronan Receptors; Hyaluronic Acid; Leukemia, Myeloid; Lewis X Antigen; Lipopolysaccharide Receptors; Macrophage Colony-Stimulating Factor; Monocytes; Neoplasm Proteins; Oncogene Proteins, Fusion; Respiratory Burst; RNA, Messenger; Tretinoin; Tumor Cells, Cultured

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is known to stimulate granulocytes, monocytes, and macrophages. We studied the effect of GM-CSF on (clonal) bone marrow (BM) cells obtained from AML patients after 7 days of culture in vitro: BM samples were obtained from 19 AML patients at diagnosis (DIA), from two patients with persisting disease (PERS), from eight patients in complete remission (CR), and from 12 healthy donors. Flow-cytometric comparison of differentiated, CD 15-positive cells or of CD34-positive blast cells before and after cultivation showed that the proportion of CD15-positive cells was increased in nine of 12 healthy BM samples, in 14 of 19 cases at DIA, in one of three cases during PERS, and in five of six cases in CR of AML. The proportion of CD34-positive cells was increased in one of 12 healthy BM samples, in seven of 19 cases at DIA, in one of two cases during PERS, and in three of seven cases in CR of AML. Southern blot analysis (SBA) performed in six cases during the course of AML, before and after cell culture, showed that clonal DNA increased after GM-CSF treatment in three of five cases studied at DIA, in six of nine cases studied in CR, in the one case studied at PERS, and in the one studied at relapse (REL). In one case of trisomy 8 at DIA a normal karyotype was demonstrated in CR. However, after 7 days of cultivation of the cells in GM-CSF the trisomy 8 was detected in two of 17 metaphases isolated from colony-cells from methylcellulose cultures. Our data show that a 7-day treatment of BM cells with GM-CSF induced a differentiation of healthy and leukemic BM cells in the great majority of cases. An enrichment of CD34-positive cells was not achieved in healthy BM samples. However, in 70% of the cases in CR and in 30% of the cases at DIA of AML, clonal CD34-positive cells were enriched. This means that GM-CSF stimulates ('primes') leukemic cell growth in vitro.

Topics: Antigens, CD34; Bone Marrow Cells; Cell Differentiation; Cell Division; Clone Cells; Granulocyte-Macrophage Colony-Stimulating Factor; Granulocytes; Hematopoietic Stem Cells; Humans; Leukemia, Myeloid; Lewis X Antigen

We have investigated the differentiation potential of blast cells in a case of acute myeloid leukemia which comprised a majority CD34- population and a minor (2%) CD34+ fraction. Blasts were cultured for 2 weeks in a combination of cytokines--c-Kit ligand, interleukin 3 and granulocyte macrophage colony-stimulating factor (SIGm mix)--together with all-trans retinoic acid or 1alpha ,25-dihydroxy vitamin D3. Maturation of blasts was assessed by morphology on Romanowsky-stained slides, changes in surface CD markers and clonogenic culture. After 7 days of culture of unseparated blasts in SIGm, most maturation was monocytic, but with retinoic acid 63% of blasts had matured into granulocytes. Vitamin D3 enhanced monocytic differentiation, with 60% of cells becoming monocytic. The percentage of CD14 and CD15 positive cells decreased over 7 days in SIGm (from 62% to 17% and from 76% to 39% for CD14 and CD15, respectively). CD14+ cell numbers were maintained, or recovered, in cultures supplemented with vitamin D3 (59% at day 7), and CD15+ cell numbers, too, remained unchanged in the presence of retinoic acid (67%) or vitamin D3 (66%). Aberrant markers CD7 and CD56 declined under any conditions. When separated, both the CD34- and CD34+ fractions showed similar changes in morphology and surface maturation markers, suggesting that these two populations may be closely related. However, only a few CD34+ cells expressed the aberrant markers present on the majority blast population. The CD34- population declined in culture while the CD34+ fraction rapidly expanded. This probably reflects the difference in progenitor content; high numbers of colony-forming cells were concentrated in the CD34+ subpopulation. We conclude that both CD34- and CD34+ populations can differentiate but only the CD34+ fraction proliferates. Primitive clonogenic CD34+ cells from this patient may generate occasional aberrant CD34+ blasts which could then differentiate into the accumulating aberrant CD34- blast population.

Topics: Acute Disease; Aged; Antigens, CD34; Antigens, CD7; CD56 Antigen; Cell Division; Clone Cells; Colony-Forming Units Assay; Hematopoietic Stem Cells; Humans; Leukemia, Myeloid; Leukocyte Common Antigens; Leukocyte Count; Leukocytes, Mononuclear; Lewis X Antigen; Lipopolysaccharide Receptors; Tumor Cells, Cultured

Autologous bone marrow transplantation (ABMT) for acute myeloid leukemia (AML) in first complete remission (CR) results in a prolonged disease-free survival (DFS) of 34%-57%. Relapse of the underlying disease is the major cause for failure of ABMT. Relapse can result fom tumor cells either surviving in the patient or reinfused in the autograft. Genetic marking of autografted cells has demonstrated that transplanted cells contribute to relapse. This finding supports the use of purged autografts. Several purging techniques have been used. Immunologic purging using the monoclonal antibody (mAb) PM-81 (anti-CD15) has been used by our center with a long-term DFS in 50% of AML patients. PM-81 reacts with 90% of AML patients, and we have used it for over 10 years. We have investigated a two-stage purging technique involving initial selection for CD34+ cells followed by mAb purging in bone marrow (BM) and peripheral blood stem cell (PBSC) harvests. This method achieved up to a 7 log diminution in leukemic cells and 1-4 log reduction in CD15+ cells, without a significant loss of hematopoietic progenitor cells. This double-purging technique has the advantages of cytoreduction, elimination of CD34- leukemic cells, and possible improvement in the clinical efficacy of purging by concentrating for CD34+ cells. Cytoreduction by CD34 enrichment followed by purging may facilitate the use of PBSC transplants in AML.

Topics: Antibodies, Monoclonal; Antigens, CD34; Antigens, Neoplasm; Bone Marrow Purging; Bone Marrow Transplantation; Cell Separation; Complement System Proteins; Flow Cytometry; Hematopoietic Stem Cells; Humans; Leukemia, Myeloid; Lewis X Antigen; Reference Values; Tumor Cells, Cultured; Tumor Stem Cell Assay

CD15 is expressed on a wide variety of tumor cells including myeloid leukemia, breast, colorectal, lung cancer cells. It is probable that the core proteins and lipids differ on the different cell types since there is marked variability in the binding of the mAb within and among the different cell types. Previously, there had only been a single mAb of the IgG class directed to CD15. The present study demonstrates the existence of one more IgG mAb (an IgG3). Unfortunately, a third mAb submitted as an IgG1, MA14, did not appear to be an IgG in our studies and a fourth mAb, MA9, submitted as an IgG1 did not have significant binding activity and also could not be confirmed as anti-CD15. An interesting finding was that all of the mAb could mediate complement-dependent cytotoxicity with rabbit serum. However, the two IgG3 mAb, MA63 (MCS-1) and MA88 (7C3), could not mediate lysis with human complement, while all of the IgM mAb could do so. It is not clear why this difference exists. CD15 is known to be expressed on mature myeloid cells in the hematopoietic lineage. The expression of CD15 on progenitor cells has been mapped by the indirect method of C'-dependent lysis and measurement of colony-forming cells. These studies have estimated that about 50% of normal CFU-GM express CD15. In the present workshop, we examined the expression of CD15 on a quantifiable cell population, the CD34 positive population.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Antibodies, Monoclonal; Antibody Specificity; Antigen-Antibody Reactions; Antigens, Neoplasm; Hematopoietic Stem Cells; Humans; Immunoglobulin G; Immunoglobulin M; Leukemia, Myeloid; Lewis X Antigen; Macromolecular Substances; Mice; Neoplasms; Neuraminidase; Rabbits; Tumor Cells, Cultured

The OMA-AML-1, acute myelogenous leukemia cell line is unique in that it spontaneously maintains both a CD34+ precursor cell compartment and a CD15+ differentiating cell compartment in vitro. A third transitional cell type with co-expression of CD34 and CD15 can also be identified in in vitro cultures. The cell line shows dynamic fluctuations in the relative sizes of these three cell compartments in suspension culture. In contrast, OMA-AML-1 fails to show phenotypic or morphologic evidence of differentiation when grown subcutaneously in immunodeficient mice. OMA-AML-1 responds to a number of hematopoietic cytokines. Delineation of cytokine responses on FACS isolated populations of CD34+ versus CD15+ cells demonstrated that proliferative responses occurred primarily at the level of the precursor cell (CD34+) while the production of endstage eosinophils occurred within the CD15+ compartment. OMA-AML-1 mimics a number of features of normal hematopoiesis and is proving to be a useful in vitro model for the study of hematopoietic differentiation.

Topics: Acute Disease; Animals; Antigens, CD; Antigens, CD34; Antigens, Differentiation, Myelomonocytic; Cell Differentiation; Cell Division; Cell Line; Cytokines; Hematopoietic Stem Cells; Humans; Immunophenotyping; Leukemia, Myeloid; Lewis X Antigen; Mice; Mice, SCID; Models, Biological; Transplantation, Heterologous; Tumor Cells, Cultured

In the present study we investigated the membrane expression of selectin ligands (CD15/Le(x), CDw65/VIM2, CD15s/sLe(x), beta 2 integrins (CD11a/LFA-1, CD11b/Mac-1) and CD45 phosphatase isoforms (CD45RA, CD45O) on leukaemic cells from 28 patients with acute myeloid malignancies cultured with and without all-trans retinoic acid (ATRA). Within each adhesion system. ATRA was able to differentially regulate distinct molecules. Furthermore, it was able to exert effects specific for acute promyelocytic leukaemia (APL) blast cells, as well as to induce a series of non-cytotype-restricted phenotypic changes. An impressive feature of ATRA induction was a simultaneous increase in the expression of CD15, CDw65 and CD11b on leukaemic promyelocytes. The sialylated antigen CD15s, however, showed results independent from the other two carbohydrates (CD15 and CDw65), suggesting a differential enzymatic regulation within the selectin ligands system. In spite of the well-recognized expression of CD11a throughout all stages of normal myeloid differentiation, APL blast cells were found to virtually lack LFA-1 expression. Moreover, ATRA was unable to promote an up-regulation of this antigen in APL, while inducing a frequent down-modulation in non-APL cases constitutively expressing this antigen. In APL cases ATRA generated an asynchronous phenotype (CD15+, CDw65+, CD11b+, CD11a-), undetectable on normally maturing myeloid cells, but consistent with the concept that incomplete differentiation, in terms of surface molecule expression, can be sufficient to obtain therapeutic results.

Topics: Acute Disease; Antigens, CD; CD11 Antigens; Cell Adhesion Molecules; Cell Differentiation; Humans; Leukemia, Myeloid; Lewis X Antigen; Neoplasm Proteins; Tretinoin

A cyclophosphamide congener, 4-hydroperoxycyclophosphamide (4HC), has been used to purge bone marrow (BM) of residual leukemia cells ex vivo for use in support of high-dose chemotherapy for patients with acute myeloid leukemia (AML) undergoing autologous BM transplantation (ABMT). The efficacy and toxicity of 4HC are dose-related. The maximally tolerated concentration, 60-100 micrograms/ml, is toxic to tumor cells but also to normal committed hematopoietic progenitor cells. The anti-CD15 monoclonal antibody (mAb) PM-81 has also been employed for purging BM in patients with AML. In some patients, all tumor cells may not be lysed due to antigenic heterogeneity. Because the two agents used individually are associated with potential limitations in terms of toxicity to normal cells and efficacy of tumor cell purging, using these agents together might have advantages. In fact, in this study the use of these two agents together in subtherapeutic concentration ranges as single agents revealed killing of cells from the HL60 and NB4 promyelocytic leukemia cell lines in addition to cells from patients with AML while sparing normal progenitor cells. Surprisingly, not only did the combination enhance killing of tumor cells, but the order of addition of the two agents was important in maximizing toxicity to tumor cells. Adding mAb+complement (C') first or simultaneously to 4HC was less effective than adding 4HC first followed by mAb + C'. This combination regimen was toxic to HL60 and NB4 leukemia cells that may not be killed by the mAb alone due to antigen-negative tumor cells or by low concentrations of 4HC.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acute Disease; Antibodies, Monoclonal; Bone Marrow Purging; Combined Modality Therapy; Cyclophosphamide; Cytotoxicity, Immunologic; Hematopoietic Stem Cells; Humans; Leukemia; Leukemia, Myeloid; Leukocytes, Mononuclear; Lewis X Antigen; Tumor Cells, Cultured

Topics: Antigens, CD; Antigens, CD34; Humans; Leukemia, Myeloid; Lewis X Antigen

It has been shown previously that multilineage human hematopoiesis is maintained within human fetal bone marrow (BM) fragments implanted into severe combined immunodeficient (SCID) mice. We describe here an application of this animal model, the SCID-hu mouse, to the study of human myeloid leukemias. BM cells from 8 patients with various types of myeloid leukemias were injected directly into human bone grafts in the SCID-hu mouse. Cells from 7 patients grew in the human marrow without spreading to the mouse marrow. Cells from 6 of these patients were successfully transferred in vivo to secondary SCID-hu recipients. The surface phenotype and the cytologic features of the leukemia cells were conserved during passage in vivo. Thus, human myeloid leukemia cells could be reproducibly propagated in the human marrow environment in SCID-hu mice. The differentiation of promyelocytic leukemia cells in the SCID-hu mice was induced by all-trans retinoic acid, suggesting that the biologic features of the leukemia cells were maintained as well. Finally, evidence for a leukemic progenitor cell population in one case of acute myelogenous leukemia was provided with this system. This model may provide a useful tool for studying the biology of human myeloid leukemia as well as for evaluating new therapeutic modalities for myeloid leukemias.

Topics: Animals; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Bone Marrow; Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukemia, Myelomonocytic, Acute; Leukemia, Promyelocytic, Acute; Lewis X Antigen; Mice; Mice, SCID; Neoplasm Transplantation; Sialic Acid Binding Ig-like Lectin 3; Transplantation, Heterologous; Tretinoin

Surface markers were studied at first relapse in 66 cases of acute myeloid leukaemia (AML), using a panel of five monoclonal antibodies directed to CD13, CD14, CD15, CD33 and CD34 antigens. At time of relapse, there was increased expression of CD33 (P = 0.002) and CD34 (P = 0.0001), and decreased expression of CD13 (P = 0.004) and CD15 (P = 0.0001) antigens by comparison to initial diagnosis. There was no strict correlation with the FAB classification. However, CD13 and CD33 expression changes preferentially affected granulocytic leukaemias. At relapse, CD14 and CD34 were significantly more expressed in monocytic than in granulocytic AML (P = 0.01 and 0.003 respectively). In a multivariate analysis, CD34 expression was associated with a low CR rate (P = 0.001) and short survival (P = 0.05), whereas CD15 expression was associated with long survival (P = 0.0004). These results suggest that AML tends to relapse with a less differentiated phenotype than observed at diagnosis and that AML with less differentiated phenotype is of poor prognosis after first relapse, as also observed at diagnosis.

Topics: Acute Disease; Adult; Aged; Antibodies, Monoclonal; Antigens, CD; Antigens, CD34; Antigens, Differentiation, Myelomonocytic; Antigens, Surface; CD13 Antigens; Female; Fluorescent Antibody Technique; Humans; Leukemia, Myeloid; Lewis X Antigen; Lipopolysaccharide Receptors; Male; Middle Aged; Multivariate Analysis; Phenotype; Prognosis; Recurrence; Sialic Acid Binding Ig-like Lectin 3

To establish the basis for the reduced expression of the X determinant on leukemic blasts and the changes in antigenic expression that occur during myeloid maturation, the presence on myeloid cells of X and related structures was examined in conjunction with studies on the activities of the glycosyltransferases involved in their biosynthesis. Expression of X and sialyl-X was weak on blasts in comparison with neutrophils despite the presence of the requisite precursor structures. Much higher levels of 3-fucosyltransferase activity were found in blasts than in neutrophils when nonsialylated substrates were used, but, whereas the enzyme in neutrophils reacted equally well with 3'-sialylated and nonsialylated acceptors, the enzyme in blasts showed a marked preference for nonsialylated substrates. 6'-Sialyltransferase activity was strong in blasts but was not detectable in neutrophils, whereas a much lower level of 3'-sialyltransferase activity was present in both blasts and neutrophils. Dimethyl sulfoxide-induced maturation of HL60 cells was associated with (1) a decrease in both 6'-sialyltransferase and 3-fucosyltransferase activities, (2) a change in the substrate specificity of 3-fucosyltransferase towards that found in mature cells, and (3) increased cell surface expression of sialyl-X. These results suggest that the reduced expression of X in myeloblasts is related to the presence of the strong 6'-sialyltransferase, which uses the precursor substrate at the expense of the 3-fucosyltransferase and prevents the synthesis of X and sialyl-X. The developmental regulation of the levels of 3'- and 6'-sialyltransferases, and the level and specificity of the 3-fucosyltransferases, therefore controls the expression of X and its degree of sialylation.

Topics: Acute Disease; Antigens, CD; beta-D-Galactoside alpha 2-6-Sialyltransferase; beta-Galactoside alpha-2,3-Sialyltransferase; Cell Differentiation; Dimethyl Sulfoxide; Enzyme Induction; Humans; Leukemia, Myeloid; Lewis X Antigen; Neutrophils; Sialyltransferases; Tumor Cells, Cultured

Using a monoclonal antibody specific to the Lewis X antigen (anti-Lex), the authors studied 103 cases of Hodgkin's disease (HD) in comparison with 57 cases of non-Hodgkin's lymphoma (NHL); three cases of granulocytic sarcoma (GS); two cases of malignant histiocytosis (MH); one case of monoblastic leukemia (ML); one case of interdigitating reticulum cell sarcoma (IRCS); six cases of histiocytosis X (HX); one case of reticulohistiocytoma (RH); 44 various reactive conditions of the lymph node (LN). Reed-Sternberg and related (R-S) cells stained selectively in 80 of 92 cases of HD (87.0%), excluding 11 cases of lymphocyte predominance type. The stain was better in B-5-fixed specimens than in formalin-fixed specimens, showing a dense deposit of reaction products at a paranuclear site and on the cell surface. The staining results were compared with those of Leu-M1 and found to be superior both qualitatively and quantitatively (detection rate of R-S cells: 87.0% versus 68.5% of Leu-M1). Granulocytes, rare epithelioid histiocytes, and some endothelial and/or erythrocytes also stained with anti-Lex. The stain had positive results in three cases of GS showing a diffuse cytoplasmic staining pattern. Of NHL, two of 29 peripheral T-cell lymphomas stained to show rare paranuclear deposits without cell surface staining. The stain had negative results in MH, ML, IRCS, HX, and RH. Of 45 reactive LN, minute subcapsular collections of Lewis X+, altered-appearing Langerhans'-like cells, were observed in all ten LN from human immunodeficiency virus (HIV)-associated persistent generalized lymphadenopathy (PGL). The stain had negative results in all other various reactive conditions of LN. In conclusion, Lewis X staining is useful as a marker for R-S cells in paraffin sections with staining results superior to those of Leu-M1. Lewis X staining also detects subcapsular clustering of altered-appearing Langerhans'-like cells in PGL, which has not been described previously and warrants additional study.

Topics: Acquired Immunodeficiency Syndrome; Antibodies, Monoclonal; Antigens, Differentiation, Myelomonocytic; Biomarkers, Tumor; Diagnosis, Differential; Histiocytic Sarcoma; Histiocytosis, Langerhans-Cell; Hodgkin Disease; Humans; Leukemia, Myeloid; Lewis X Antigen; Lymph Nodes; Lymphoma, Non-Hodgkin; Male; Middle Aged; Staining and Labeling

Although monoclonal antibodies (MoAbs) to CD15, especially PM-81, react with leukemic blasts from the majority of patients with acute myeloid leukemia (AML), a small subset of patients have cells that are CD15 negative or dim. We determined previously that neuraminidase will increase the reactivity of PM-81 with AML blasts, as well as blasts from many patients with acute lymphoblastic leukemia (ALL). In this report, we describe the laboratory results and clinical course of the first patient with AML whose harvested bone marrow was treated with neuraminidase prior to MoAbs and complement treatment. Neuraminidase increased the percentage of the patient's leukemia cells that reacted with PM-81 from 18% to 90% and more than doubled the percentage of AML blasts that were lysed by PM-81 and complement. The patient suffered no acute toxicity, engrafted rapidly, and was transfusion independent by day 21 post-ABMT. This report demonstrates the probable safety and efficacy of pretreatment of bone marrow with neuraminidase, and increases the number of patients with AML or ALL who may benefit from ABMT using marrow purging with MoAb to CD15.

Topics: Acute Disease; Antibodies, Monoclonal; Antigens, Differentiation; Bone Marrow; Bone Marrow Transplantation; Complement System Proteins; Humans; Leukemia, Myeloid; Lewis X Antigen; Male; Middle Aged; Neuraminidase; Transplantation, Autologous

Human x mouse myeloid cell hybrids were obtained after fusion of human leucocytes and the murine myeloid cell line WEHI-TG. The hybrids were tested for reactivity with a panel of monoclonal antibodies with a known myelocytic, monocytic, or myelomonocytic specificity. Twenty antibodies, all of which bind specifically to the surface of human myeloid cells, exhibited very similar reactivity patterns with the hybrid clones. Chromosomal analysis of hybrid cell metaphases revealed that the gene(s) involved in the expression of the antigen(s) recognized by these antibodies must be located on human chromosome 11 in the region q12-qter. These results are compatible with the evidence obtained from other studies that several, if not all, of the myeloid-specific antibodies used are reactive with a similar antigenic determinant present on human myeloid cells.

Topics: Animals; Antibodies, Monoclonal; Antigens, Neoplasm; Antigens, Surface; Chromosomes, Human, 6-12 and X; Epitopes; Genes; Humans; Leukemia, Myeloid; Lewis X Antigen; Mice; Oligosaccharides; Translocation, Genetic