Aberrant Phenotypes in Acute Myeloid Leukemia and Its Relationship with Prognosis and Survival: A Systematic Review and Meta-Analysis

Lucio   Henrique Sousa Pinheiro; Louise   Dantas Trindade; Amanda  Fernandes de Oliveira Costa; Nathanielly   de Lima Silva; Alex   Freire Sandes; Marco  Antônio Prado Nunes; Cristiane   Bani Correa; Carlos  Arthur Cardoso Almeida; Geydson  Silveira da Cruz; Divaldo  Pereira de Lyra Junior; Dulce   Marta Schimieguel

doi:10.18502/ijhoscr.v14i4.4484

Lucio Henrique Sousa Pinheiro
Louise Dantas Trindade
Amanda Fernandes de Oliveira Costa
Nathanielly de Lima Silva
Alex Freire Sandes
Marco Antônio Prado Nunes
Cristiane Bani Correa
Carlos Arthur Cardoso Almeida
Geydson Silveira da Cruz
Divaldo Pereira de Lyra Junior
Dulce Marta Schimieguel

DOI: https://doi.org/10.18502/ijhoscr.v14i4.4484

Keywords: Aberrant phenotype, Acute myeloid leukemia, Immunophenotyping, Prognosis, Survival

Abstract

Background: The aim of this review was to evaluate the influence of aberrant phenotypes in prognosis and survival in acute myeloid leukemia (AML) patients by multiparametric flow cytometry.

Materials and Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a review of PubMed, Scopus, Science Direct and Web of Science was carried out through 1998 to 2016, conducted by two reviewers independently, evaluating titles, abstracts and full-texts of the selected studies.

Results: Ten studies were included on this review, in which the aberrant phenotype expression of 17 markers were detected in AML patients. From these, 11 aberrant phenotypes were associated with prognosis, which eight had shown negative impact on prognosis: CD7, CD56, CD15, CD2, CD3, CD90^low, CD123^high, CD117^high, and three others were associated with good prognosis: CD19, CD98^high and CD117⁺/CD15⁺. Meta-analysis showed that aberrant expression of CD56 as a poor prognostic marker with unfavorable outcomes is implicated in decreased overall survival in AML patients in 28 months (95% CI: 0.62 to 0.92).

Conclusion: This was observed when there was association between CD56 expression and other prognostic factors, influencing on patients’ management care and treatment.