Vol 55, No 5 (2024)
Original research article
Published online: 2024-10-31

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Relationship between reticular fibrosis with platelet surface markers (CD41A, CD42A, CD42B, CD61) and prognostic markers (WBC, PLT) in acute promyelocytic leukemia

Ahmet Kaya1, Mehmet Ali Erkurt1, Irfan Kuku1, Emin Kaya1, Ilhami Berber1, Ahmet Sarıcı1, Zehra Bozdağ2, Soykan Biçim3, Süleyman Arslan1, Fatma Hilal Yagın4
DOI: 10.5603/ahp.99939
Acta Haematol Pol 2024;55(5):252-259.

Abstract

Introduction: Acute promyelocytic leukemia is a type of leukemia in which abnormal promyelocytes predominate in the peripheral blood and bone marrow. Its clinical course and treatment differ from those of other acute myeloid leukemias. It is necessary to elucidate bone marrow fibrosis in acute promyelocytic leukemia.

Material and methods: Our study included 44 patients who were followed up and treated for acute promyelocytic leukemia in the adult hematology clinic of Turgut Özal Medical Center, Malatya, Türkiye. The relationship between CD 41A, CD 42A, CD 42B, and CD61 levels in flow cytometry and prognostic markers (WBC, PLT) was studied at diagnosis, and the fibrosis grade in the bone marrow pathology taken at diagnosis was examined. Results: The relationship between the fibrosis grade in bone marrow biopsy at diagnosis and PLT, WBC, CD41A, CD42A, CD42B and CD61 values was statistically insignificant (p > 0.05). There was no statistical difference between genders according to fibrosis results in bone marrow biopsy at diagnosis (p > 0.05). There was a statistically significant age difference (p < 0.05). At the time of diagnosis, the bone marrow fibrosis grade of 12 patients was found to be 2 or higher. We observed an increase in the fibrosis grade in bone marrow in three patients, a decrease in fibrosis in five patients, and no change in the fibrosis grade in six patients after treatment. There was no relationship between platelet surface markers and risk groups during the diagnosis of acute promyelocytic leukemia. While no correlation was detected between disseminated intravascular coagulation and platelet surface markers after treatment, a negative correlation was observed with pre-treatment INR.

Conclusions: Reticular fibrosis may be seen in patients diagnosed with acute promyelocytic leukemia. The cause of reticular fibrosis is unclear. Elevation of flow cytometric platelet surface markers in blasts at diagnosis are not directly related to reticular fibrosis. There are conflicting results in the regression of reticular fibrosis after treatment.

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References

  1. Sharma A, Yang J, Singh V. Epidemiology and early mortality patterns of acute promyelocytic leukemia in the United States. Ann Hematol. 2023; 102(5): 1053–1062.
  2. Mantha S, Tallman MS, Soff GA. What's new in the pathogenesis of the coagulopathy in acute promyelocytic leukemia? Curr Opin Hematol. 2016; 23(2): 121–126.
  3. Lin J, Han LX, Qian J, et al. Expression patterns of specific promyelocytic/retinoic acid receptor-alpha transcripts in patients with acute promyelocytic leukemia. Int J Lab Hematol. 2010; 32(3): 344–350.
  4. Arber D, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016; 127(20): 2391–2405.
  5. Gagnon MF, Berg HE, Meyer RG, et al. Typical, atypical and cryptic t(15;17)(q24;q21) (PML::RARA) observed in acute promyelocytic leukemia: A retrospective review of 831 patients with concurrent chromosome and PML::RARA dual-color dual-fusion FISH studies. Genes Chromosomes Cancer. 2022; 61(10): 629–634.
  6. Dimov ND, Medeiros LJ, Kantarjian HM, et al. Rapid and reliable confirmation of acute promyelocytic leukemia by immunofluorescence staining with an antipromyelocytic leukemia antibody: the M. D. Anderson Cancer Center experience of 349 patients. Cancer. 2010; 116(2): 369–376.
  7. Khoury JD, Solary E, Abla O, et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic Neoplasms. Leukemia. 2022; 36(7): 1703–1719.
  8. Frelinger AL, Spurgeon BEJ. Clinical Cytometry for Platelets and Platelet Disorders. Clin Lab Med. 2023; 43(3): 445–454.
  9. Nakayama S, Yokote T, Hiraoka N, et al. Transforming growth factor β- and interleukin 13-producing mast cells are associated with fibrosis in bone marrow. Hum Pathol. 2017; 62: 180–186.
  10. Abou Dalle I, Nassif S, Bazarbachi A. Acute promyelocytic leukemia with increased bone marrow reticulin fibrosis: Description of three cases and review of the literature. Hematol Oncol Stem Cell Ther. 2018; 11(2): 99–104.
  11. Izuta M, Kuwamoto S, Kamiya T, et al. Imaging of Liver Tissues Using a Combination of Silver Impregnation and Low-Vacuum Scanning Electron Microscopy; A Simple Method for the High-Resolution Visualization of Reticulin Structures with Applicability to a Quantitative Analysis. Yonago Acta Med. 2023; 66(1): 78–86.
  12. Thiele J, Kvasnicka HM, Facchetti F, et al. European consensus on grading bone marrow fibrosis and assessment of cellularity. Haematologica. 2005; 90(8): 1128–1132.
  13. Mori A, Wada H, Okada M, et al. Acute promyelocytic leukemia with marrow fibrosis at initial presentation: possible involvement of transforming growth factor-beta(1). Acta Haematol. 2000; 103(4): 220–223.
  14. Lam WK, Law YF, Yip SF. Resolution of platelet count interference due to cytoplasmic fragments of leukaemic cells by flow cytometry in acute myeloid leukaemia. Int J Lab Hematol. 2022; 44(6): 983–985.
  15. Losada R, Cabrera H, Hernández P, et al. Bone marrow reticulin fibrosis at diagnosis in promyelocytic leukaemia treated with all-trans retinoic acid has no adverse prognosis. Acta Haematol. 2002; 108(2): 111–112.
  16. Beckman EN, Brown AW. Normal reticulin level in iliac bone marrow. Arch Pathol Lab Med. 1990; 114(12): 1241–1243.
  17. Hagemeyer CE, Peter K. Targeting the platelet integrin GPIIb/IIIa. Curr Pharm Des. 2010; 16(37): 4119–4133.
  18. Li R. Recent advances on GPIb-IX-V complex. Platelets. 2022; 33(6): 809–810.