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Journal of Oncology
Volume 2012, Article ID 135186, 7 pages
Research Article

Myeloid Antigen Expression in Childhood Acute Lymphoblastic Leukemia and Its Relevance for Clinical Outcome in Indonesian ALL-2006 Protocol

1Pediatric Hematology Oncology Division, Department of Pediatrics, Dr. Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Jl. Kesehatan No. 1, Yogyakarta 55281, Indonesia
2Pediatric Oncology/Hematology Division, Department of Pediatrics, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
3Department of Epidemiology and Biostatistics, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
4Department of Hematology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands

Received 12 May 2012; Accepted 15 September 2012

Academic Editor: Gertjan Kaspers

Copyright © 2012 Eddy Supriyadi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The frequency of acute lymphoblastic leukemia (ALL) patients expressing myeloid antigens on their ALL cells varies between 5 and 36% in several different studies. The clinical relevance of myeloid antigen expression in childhood ALL is controversial. In Indonesian patients, no data were present. Therefore, in Yogyakarta, Indonesia, we analyzed 239 ALL patients who were immunophenotyped including myeloid markers (CD13, CD33, CD117, and/or cMPO). Myeloid antigen expression was found in 25% of patients. Expression of myeloid antigen in B-lineage leukemia was 27%, and in T-lineage leukemia, it was 18% ( ). No association was found between myeloid antigen expression and clinical or biological features. In the whole cohort of patients we did not find a significant association between myeloid antigen expression and survival, although leukemia-free survival at 3 years was higher in the myeloid-negative patients (73% ± 6%) compared to myeloid-positive patients (67% ± 8%). Interestingly, in T-ALL patients, expression of myeloid antigens was an independent adverse prognostic factor (hazard ratio: 3.26, 95% CI: 1.06–9.98, ). Kaplan-Meier analysis for event-free survival was also significant (log rank ) in this subgroup. In conclusion, in the Indonesian ALL population, in particular, myeloid antigen-expressing T-ALL patients had a higher chance of having induction failure.