Proportions of Cells Expressing CD38-/CD34+, CD38+/CD34+, CD19+/CD34+, or CD13,33+/CD34+ in the Regenerating Bone Marrows During Complete Remission of Acute Leukemia or After Bone Marrow Transplantation

Jimin Kahng; So-Young Shin; Kyungja Han

doi:10.3343/kjlm.2007.27.6.406

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Kahng, Shin, and Han: Proportions of Cells Expressing CD38-/CD34+, CD38+/CD34+, CD19+/CD34+, or CD13,33+/CD34+ in the Regenerating Bone Marrows During Complete Remission of Acute Leukemia or After Bone Marrow Transplantation

Original Article

Korean J Leg Med 2007;27(6):406-413.

Published online: 14 February 2007

DOI: https://doi.org/10.3343/kjlm.2007.27.6.406

Proportions of Cells Expressing CD38-/CD34+, CD38+/CD34+, CD19+/CD34+, or CD13,33+/CD34+ in the Regenerating Bone Marrows During Complete Remission of Acute Leukemia or After Bone Marrow Transplantation

Jimin Kahng, M.D., So-Young Shin, M.D., Kyungja Han, M.D.

Department of Laboratory Medicine, Catholic University College of Medicine, Seoul, Korea

Received 21 August 200724 October 2007 Accepted 9 November 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

The hemopoietic stem cells increase in number during the regeneration after chemotherapy or bone marrow transplantation (BMT). Although the proportion of hemopoietic stem cells and their differentiation have been studied by immunophenotyping using the flow cytometry, no substantial research efforts have been directed toward the regenerating marrow. We attempted to discover the proportions of undifferentiated stem cells, committed stem cells, B cell precursors, and myeloid precursors in the regenerating bone marrows during complete remission (CR) and after engraftment of BMT.

Methods

Bone marrow samples from 82 patients with acute leukemia in CR and from 25 patients after BMT engraftment, along with 22 control samples, were used to find the numbers of CD38-/CD34+, CD38+/CD34+, CD19+/CD34+, and CD13,33+/CD34+ cells in the large lymphocyte gate by flow cytometry. We cross-analyzed our results in terms of groups: CR, BMT, and initial diagnosis groups. We performed significance tests on age, relapse, chromosomal abnormalities, clinical outcomes, and initial immunophenotypes of the leukemic cells.

Results

The proportions of CD38-/CD34+, CD38+/CD34+, CD19+/CD34+, and CD13,33+/CD34+ cells are more highly distributed in acute B-lymphoblastic leukemia than the normal group and also in the CR than the BMT group. CD19+/CD34+ cells were increased in the relapse group and CD38+/CD34+, CD19+/CD34+, and CD13,33+/CD34+ cells were increased in the group with chromosomal abnormality. The results were irrelevant to the initial immunophenotype of the leukemic blasts.

Conclusions

The increases of the markers spanned too widely to apply one specific cutoff value to analyze them. They seemed to be the results of normal regeneration, irrelevant to relapse or initial immunophenotype of leukemic blasts.

Keywords: CD38-/CD34+, CD38+/CD34+, CD19+/CD34+, CD13,33+/CD34+, Regenerating bone marrow, Acute leukemia

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Fig. 1.

Dot plot scattergrams of bone marrow cells of a B-ALL patient in complete remission stained with anti-CD38-FITC/anti-CD34-PerCP (A, B). The large lymphocyte gate was set using forward scatter (FSC) and side scatter (SSC) characteristics (A). The CD38+/CD34+ cells in the gate (upper right quadrant) was 4.30% (B).

Table 1.

Frequencies of cells expressing CD38-/CD34+, CD38+/CD34+, CD19+/CD34+, or CD13,33+/CD34+ in the bone marrow during complete remission of acute leukemia or after bone marrow transplantation

	Normal control (N=22)	B-ALL (N=76)	T-ALL (N=10)	AML (N=10)	ABL (N=11)
CD38-/CD34+	0.30±0.24 (0.00-0.85)	0.77±0.79 (0.02-4.95)	0.46±0.25 (0.04-0.79)	0.41±0.37 (0.00-1.19)	1.14±1.80 (0.18-6.38)
		P=0.013	P=1	P=1	P=0.117
CD38+/CD34+	0.89±0.59 (0.14-2.71)	2.66±2.57 (0.09-11.28)	4.06±3.95 (0.12-10.84)	0.74±0.51 (0.18-1.93)	2.45±2.40 (0.19-7.62)
		P=0.004	P=1	P=1	P=0.138
CD19+/CD34+	0.32±0.28 (0.00-1.06)	1.35±1.64 (0.05-9.75)	1.76±2.35 (0.07-7.19)	0.54±0.50 (0.01-1.71)	1.40±1.28 (0.32-4.46)
		P=0.002	P=1	P=1	P=0.005
CD13,33+/CD34+	0.32±0.26 (0.04-1.35)	1.32±1.64 (0.02-8.85)	1.45±1.80 (0.08-6.15)	0.27±0.13 (0.13-0.52)	0.94±0.63 (0.11-2.01)
		P<0.001	P=0.124	P=1	P=0.022

^∗ mean±SD % in the large lymphocyte gate (range in the parentheses).

Abbreviations: B-ALL, acute B-lymphoblastic leukemia; T-ALL, acute T-lymphoblastic leukemia; AML, acute myeloid leukemia; ABL, acute biphenotypic leukemia.

Table 2.

The differences of the frequencies of cells expressing CD38-/CD34+, CD38+/CD34+, CD19+/CD34+, or CD13,33+/CD34+ according to the variables

	Status		Relapse		Chromosomal abnormality		Clinical outcome
	CR (N=82)	BMT (N=25)	Negative (N=85)	Positive (N=22)	Negative (N=50)	Positive (N=57)	CR & Survive (N=103)	Expire (N=4)
CD38-/CD34+	0.87±0.98	0.36±0.30	0.92±1.31	0.62±0.70	0.78±1.14	0.66±0.60	0.68±0.88	0.54±0.26
	(0.02-6.38)	(0.00-1.19)	(0.06-6.38)	(0.00-4.95)	(0.00-6.38)	(0.02-3.16)	(0.00-6.38)	(0.29-0.90)
	P=0.003		P=0.176		P=0.523		P=0.934
CD38+/CD34+	2.98±2.78	1.42±1.87	2.30±2.61	2.30±2.07	1.83 + 2.15	2.93±2.94	2.21±2.50	2.60±3.09
	(0.09-11.28)	(0.12-7.94)	(0.09-11.28)	(0.18-7.22)	(0.12-8.58)	(0.09-11.28)	(0.09-11.28)	(0.90-7.22)
	P=0.001		P=0.509		P=0.012		P=0.591
CD19+/CD34+	1.54±1.77	0.65±0.66	1.09±1.54	1.45±1.44	0.97±1.41	1.45±1.74	1.07±1.45	2.04±2.75
	(0.05-9.75)	(0.01-2.88)	(0.00-9.75)	(0.10-6.13)	(0.01-7.19)	(0.07-9.15)	(0.00-9.75)	(0.34-6.13)
	P=0.012		P=0.033		P=0.017		P=0.406
CD13,33+/CD34+	1.33±1.61	0.78±1.18	1.03±1.38	1.13±1.66	0.98±1.66	1.21±1.35	0.96±1.14	0.92±0.26
	(0.02-8.85)	(0.08-5.96)	(0.02-8.85)	(0.11-8.11)	(0.04-8.85)	(0.02-8.11)	(0.02-8.85)	(0.73-1.28)
	P=0.012		P=0.519		P=0.006		P=0.550

^∗ mean±SD % in the large lymphocyte gate (range in the parentheses).

Abbreviations: CR, complete remission; BMT, bone marrow transplantation.

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