An analysis of the impact of CD56 expression in de novo acute promyelocytic leukemia patients treated with upfront all-trans retinoic acid and anthracycline-based regimens

Marta Sobas*, Pau Montesinos, Blanca Boluda, Teresa Bernal, Edo Vellenga, Josep Nomdedeu, Jose Gonzalez-Campos, Maria Chillon, Aleksandra Holowiecka, Jordi Esteve, Juan Bergua, Jose David Gonzalez-Sanmiguel, Cristina Gil-Cortes, M. Tormo, Olga Salamero, Felix Manso, Isolda Fernandez, Javier de la Serna, Maria-Jose Moreno, Manuel Perez-EncinasIsabel Krsnik, Josep-Maria Ribera, Lourdes Escoda, Bob Lowenberg, Miguel Angel Sanz, J. M. Beltran de Heredia, J. M. Hernandez, J. Arias, F. Ramos, A. Roman, J. de la Serna, S. Negri, C. Rayon, J. Esteve, F. J. Fernandez-Calvo, J. Diaz-Mediavilla, C. Gil, M. Olave, E. Amutio, C. Pedro, A. Gorosquieta, M. Viguria, M. Zudaire, T. Molero, M. J. Sayas, R. Guardia, J. Martinez, M. R. de Groot, H. C. Schouten, PETHEMA Cooperative Grp, HOVON Cooperative Group, PALG Cooperative Group, GATLA Cooperative Group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Web of Science)


Out of 956, there were 95 (10%) CD56+ APL patients treated with PETHEMA ATRA and chemotherapy. CD56+ expression was associated with high WBC, BCR3 isoform, and co-expression of CD2, CD34, CD7, HLA-DR, CD15, and CD117 antigens. CD56+ vs CD56- APL presented higher induction death rate (16% vs 8%, p = .02) and 5-years cumulative incidence of relapse (33% versus 10%, p = .006), irrespectively of the Sanz score (low-risk 47% versus 5%, p <.001; intermediate 23% versus 7%, p <.001; and high-risk 42% versus 21%, p = .007). In the multivariate analysis, CD56 + (p <.0001), higher relapse-risk score (p = .001), and male gender (p = .05) retained the independent predictive value. CD56+ APL also showed a greater risk of CNS relapse (6% versus 1%, p <.001) and lower 5-year OS (75% versus 83%, p = .003). The AIDA-based LPA2012 trial, with an intensified consolidation schedule for CD56+ APL, will elucidate whether an intensified consolidation schedule could mitigate the relapse rate in this setting.

Original languageEnglish
Pages (from-to)1030-1035
Number of pages6
JournalLeukemia & Lymphoma
Issue number4
Publication statusPublished - 21 Mar 2019


  • Acute promyelocytic leukemia
  • CD56
  • ATRA
  • chemotherapy
  • prognostic
  • relapse
  • RISK

Cite this