Iraqi Journal of Hematology · Published 2025-07-01 · DOI 10.4103/ijh.ijh_70_25
BACKGROUND: Acute myeloid leukemia (AML) is a clonal malignancy affecting hemopoietic immature cells, characterized by uncontrolled proliferation and impaired differentiation of these cells, causing their accumulation in the marrow and ultimately marrow failure. Cluster of differentiation 56 or CD56 antigen is typically found on the majority of healthy natural killer cells, some cytotoxic T-cells, and a number of CD4+ T-cells. However, in around 20%–40% of AML patients, it is aberrantly expressed. OBJECTIVES: The aims of this study were to determine the frequency of abnormal CD56 expression in adult de novo AML blasts and evaluate its correlation with complete blood count (CBC), blast percentages, AML subtypes, extramedullary disease, and induction therapy response. MATERIALS AND METHODS: Thirty adult cases (>15 years) with de novo AML were consequently selected in the period from August 1, 2023, to January 30, 2024. On average, their age was 38.97 years old. Cytomorphology, with the use of flow cytometry in suspected instances, was used to diagnose all AML patients in accordance with the World Health Organization criteria for AML. At the first diagnosis, the blast cell percentage was determined by counting the cells on the peripheral blood (PB) and bone marrow (BM)-stained films, and the CBC was performed using a 5-part automated analyzer. Using an eight-color (BD FACSCanto II USA), aberrant CD56 expression was examined. Extramedullary manifestations were determined at the time of diagnosis and determine its correlation with CD56 expression. Three weeks after the completion of the first chemotherapy cycle, the patients were re-assessed for the accomplishment of complete remission. RESULTS: Expression of CD56 was observed on blast cells in 26.7% of AML patients. Patients with AML exhibiting positive CD56 expression were older compared to those with negative expression. Furthermore, CD56 expression was more prevalent in males, with the male: female ratio of 7:1. Nevertheless, no statistically significant correlations were identified between either of the aberrant expressions and age or sex. CD56 expression was significantly higher in blasts of AML subtypes with monocytic differentiation. The total white blood cell (WBC) count and the percentage of PB and/or BM blast cells in AML patients exhibiting positive expression were significantly higher compared to those without such expression. Significant correlations were observed between aberrant CD56 expression and extramedullary manifestations and with the nonresponsiveness to the induction therapy. CONCLUSION: There is evidence of aberrant CD56 expression in around a quarter percent of all instances of AML. It was discovered that neither the age nor the gender of the patient had a significant correlation with this expression. It was shown that monocytic AML subtypes had a higher expression of CD56. It was shown that individuals with AML who had aberrant CD56 expression had considerably higher overall WBC, as well as greater percentages of blast cells in both the PB and BM. There was a substantial association between the abnormal expression of CD56 and the extramedullary symptoms, as well as the nonresponsiveness to the induction treatment.
Abstract from DOAJ. Public domain (CC0 1.0).
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