Related Experiment Video

Updated: Sep 8, 2025

Flow Cytometry to Estimate Leukemia Stem Cells in Primary Acute Myeloid Leukemia and in Patient-derived-xenografts, at Diagnosis and Follow Up
09:01

Flow Cytometry to Estimate Leukemia Stem Cells in Primary Acute Myeloid Leukemia and in Patient-derived-xenografts, at Diagnosis and Follow Up

Published on: March 26, 2018

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Prognostic Impact and Phenotype of Residual Acute Myeloid Leukemia Stem Cells

Samiha Jaddaoui, Hanaa Bencharef, Mouna Lamchahab

    Clinical Laboratory
    |June 15, 2022
    PubMed
    Abstract

    Insights

    Leukemia stem cells (LSCs) are therapy-resistant and predict relapse in acute myeloid leukemia (AML). Detecting CD34+CD38-CD123+ LSCs with aberrant HLA DR and CD117 markers aids prognosis.

    Area of Science:

    • Hematology
    • Immunology
    • Cancer Research

    Background:

    • Leukemia stem cells (LSCs) exhibit higher therapy resistance than leukemic blast cells, contributing to measurable residual disease (MRD).
    • The frequency of CD34+CD38- cells is a significant predictor of relapse in acute myeloid leukemia (AML).
    • Accurate assessment of MRD is crucial for therapeutic decisions in AML patients.

    Purpose of the Study:

    • To develop a protocol for accurate and reproducible immunophenotypic detection of measurable residual stem cell disease in AML.
    • To evaluate the prognostic value of LSCs in AML patients.
    • To identify specific markers for distinguishing LSCs from normal hematopoietic stem cells.

    Main Methods:

    • Analysis of phenotype and frequency of CD45dim CD34+CD38- cells in bone marrow samples from 54 adult AML patients.
    • Utilized six-color flow cytometry and a one-tube assay for immunophenotypic analysis.
    • Gating strategy focused on CD34+CD38- stem cells and leukemia-associated immunophenotypes.

    Main Results:

    • Leukemia stem cells (LSCs) were identified as CD34+CD38- cells with positivity for CD123 and/or aberrant expression of CD117 and HLA DR.
    • A statistically significant difference was observed in the expression of primitive markers (CD117 and HLA DR) on LSCs.
    • LSCs persisted after complete remission in 50% of AML patients post-induction.

    Conclusions:

    • The phenotype CD34+CD38-CD123+ combined with aberrant HLA DR and CD117 expression effectively detects LSCs.
    • Detection of these LSCs is indicative of a poor prognosis in AML patients.
    • This immunophenotypic approach enhances MRD assessment for improved therapeutic strategies in AML.

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