Gain of CD26 expression on the malignant T-cells in relapsed erythrodermic leukemic mycosis fungoides
JOURNAL OF CUTANEOUS PATHOLOGY
Authors: Cedeno-Laurent, Filiberto; Wysocka, Maria; Obstfeld, Amrom E.; Novoa, Roberto A.; Vittorio, Carmela C.; Kim, Ellen J.; Weng, Wen-Kai; Rook, Alain H.
Abstract
Loss of CD26 surface expression on the circulating malignant T-cell is the most widely accepted diagnostic marker in patients with leukemic cutaneous T-cell lymphoma (CTCL). CTCL cases with reemergence of CD7 and/or CD26 surface expression are unusual and of uncertain prognosis. We report the case of an erythrodermic leukemic mycosis fungoides patient who had achieved temporary remission after several months on multimodality immunotherapy and extracorporeal photopheresis, but who relapsed with aggressive disease phenotypically characterized by CD4+ T-cells with high CD26 expression. Polymerase chain reaction studies and high-throughput sequencing analyses from peripheral blood mononuclear cells at presentation and relapse consistently showed an identical clonal T-cell receptor suggesting evolution of her original malignant clone which lacked CD26 expression. Interestingly, quantitative expression of the sialomucin, CD164, mirrored her clinical picture, thus favoring its reliability as a novel biomarker in CTCL.
P-glycoprotein and multidrug resistance-associated protein-1 expression in acute myeloid leukemia: Biological and prognosis implications
INTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY
Authors: da Silveira Junior, Lenilton Silva; Soares, Victor de Lima; Jardim da Silva, Alessandra Suelen; Gil, Erica Aires; Pereira de Araujo, Maria das Gracas; Merces Goncalves, Ciro Alexandre; Paiva, Aldair de Souza; Moura de Oliveira, Taissa Maria; de Medeiros Oliveira, Gustavo Henrique; Cavacanti e Silva, Dany Geraldo Kramer; de Araujo Moura Lemos, Telma Maria; Moretti Rebecchi, Ivanise Marina; de Farias Sales, Valeria Soraya; Luchessi, Andre Ducati; Cavalcanti Junior, Geraldo Barroso
Abstract
Background Despite the advances in the cure rate for acute myeloid leukemia (AML), a considerable number of patients die from the disease due to the occurrence of multidrug resistance (MDR). Overexpression of the transporter proteins, such as P-glycoprotein (Pgp) and multidrug resistance-associated protein (MRP), confers resistance to the treatment of these leukemias. Methods To analyze the expression of the Pgp and MRP1 in patients with AML and determine their correlation between expression and demographic, clinical, and laboratorial variables, bone marrow and peripheral blood samples from 346 patients with a diagnosis of AML were assessed for the expression of Pgp and MRP1 by flow cytometry. Results The expression of Pgp and MRP1 was found in 111 (32.1%) and 133 (38.4%) patients, respectively, with greater prevalence in older patients and lower in children, while also observing a high incidence in patients with refractory, recurrence, and secondary disease in comparison with the cases of de novo AML. Regarding the laboratory findings, we observed an association between the expression of Pgp and MRP1 and CD34, CD7, and also M7, M5a, and M2-AML of French-American-British classification. Conclusions The results showed that the detection of MDR phenotype by flow cytometry can be a molecular marker for prognosis of patients with AML.
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