Definition of AML susceptibility and classification using monoclonal antibodies.

Of 112 patients with acute leukemia 13 exhibited terminal deoxyribonucleotidyl transferase activity (TdT) with a cell phenotype characterized by the presence of early or mature monocyte differentiation antigens detected by monoclonal antibodies and elevated serum lysozyme. These cells were either unclassifiable by cytochemical analysis or fell into the M2 or M5 categories by the French-American-British classification. These leukemias appear to form a distinct nosologic entity representing a malignant transformation among early cells in the monocyte lineage. Among 60 patients with acute myelogenous leukemia 87% expressed the polymorphic Ia antigen detected by monoclonal antibody 109d6 compared to an incidence of 40.5% in the control population, relative risk 9.2. Evidence was obtained that this antigen was present in healthy family members and remission B-cells and monocytes of patients, and that its presence was associated with a genetically defined susceptibility state for the development of acute myelogenous leukemia.