Aberrant marker expression patterns on the CD34+CD38- stem cell compartment in acute myeloid leukemia allows to distinguish the malignant from the normal stem cell compartment both at diagnosis and in remission

Leukemia. 2007 Aug;21(8):1700-7. doi: 10.1038/sj.leu.2404754. Epub 2007 May 24.


Acute myeloid leukemia (AML) is generally regarded as a stem cell disease. In CD34-positive AML, the leukemic stem cell has been recognized as CD38 negative. This CD34+CD38- population survives chemotherapy and is most probable the cause of minimal residual disease (MRD). The outgrowth of MRD causes relapse and MRD can therefore serve as a prognostic marker. The key role of leukemogenic CD34+CD38- cells led us to investigate whether they can be detected under MRD conditions. Various markers were identified to be aberrantly expressed on the CD34+CD38- population in AML and high-risk MDS samples at diagnosis, including C-type lectin-like molecule-1 and several lineage markers/marker-combinations. Fluorescent in situ hybridization analysis revealed that marker-positive cells were indeed of malignant origin. The markers were neither expressed on normal CD34+CD38- cells in steady-state bone marrow (BM) nor in BM after chemotherapy. We found that these markers were indeed expressed in part of the patients on malignant CD34+CD38- cells in complete remission, indicating the presence of malignant CD34+CD38- cells. Thus, by identifying residual malignant CD34+CD38- cells after chemotherapy, MRD detection at the stem cell level turned out to be possible. This might facilitate characterization of these chemotherapy-resistant leukemogenic cells, thereby being of help to identify new targets for therapy.

Publication types

  • Comparative Study

MeSH terms

  • ADP-ribosyl Cyclase 1 / metabolism*
  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Antigens, CD34 / metabolism*
  • Biomarkers, Tumor / metabolism*
  • Bone Marrow / metabolism
  • Bone Marrow / pathology
  • Female
  • Flow Cytometry
  • Hematopoietic Stem Cells / cytology
  • Hematopoietic Stem Cells / metabolism*
  • Humans
  • Immunophenotyping
  • In Situ Hybridization, Fluorescence
  • Leukemia, Myeloid / diagnosis*
  • Leukemia, Myeloid / metabolism
  • Male
  • Middle Aged
  • Neoplasm, Residual / diagnosis*
  • Neoplasm, Residual / metabolism
  • Neoplastic Stem Cells / metabolism*
  • Neoplastic Stem Cells / pathology
  • Prognosis
  • Remission Induction
  • Risk Factors
  • Survival Rate


  • Antigens, CD34
  • Biomarkers, Tumor
  • ADP-ribosyl Cyclase 1