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Related Experiment Videos

Acute leukemias with unusual immunophenotypes.

M H Park1, Y S Yang, H I Cho

  • 1Department of Clinical Pathology, Seoul National University College of Medicine, Korea.

Journal of Korean Medical Science
|December 1, 1992
PubMed
Summary

Immunophenotyping accurately diagnoses most acute leukemia cases, even those with minor deviations in cell markers. Unusual immunophenotypes, like biphenotypic leukemia, may indicate a poor prognosis and resistance to chemotherapy.

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Area of Science:

  • Hematology
  • Immunology
  • Oncology

Background:

  • Immunophenotyping is crucial for acute leukemia diagnosis.
  • Phenotypic ambiguity, or lineage infidelity, can complicate diagnosis.
  • Understanding unusual immunophenotypes is important for prognosis.

Purpose of the Study:

  • To assess the incidence and clinical significance of phenotypic ambiguity in acute leukemia.
  • To classify immunophenotypes based on ectopic antigen expression.
  • To evaluate the diagnostic accuracy of immunophenotyping.

Main Methods:

  • Analysis of immunophenotypic patterns in 266 acute leukemia cases over two years.
  • Use of immunofluorescence stains with a panel including TdT, SmIg, and nine surface antigens.

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  • Classification of immunophenotypes into four groups based on ectopic antigen expression.

    • Main Results:

    • 91.7% of cases showed conventional patterns (Group A).
    • 3.0% exhibited low-grade deviation with single ectopic antigens (Group B).
    • 4.2% showed promiscuous coexpression (Group C), including biphenotypic leukemia.
    • 1.1% were unclassifiable (Group D).
    • Biphenotypic and unclassifiable cases showed poor response to chemotherapy.
    • Ectopic antigen expression varied across acute myeloid leukemia (8.1%), B-lineage acute lymphoblastic leukemia (4%), and T-lineage acute lymphoblastic leukemia (25%).

    Conclusions:

    • Immunophenotyping accurately diagnoses nearly 95% of acute leukemia cases.
    • Mild deviations in antigenic patterns do not hinder diagnosis.
    • Biphenotypic and unclassifiable immunophenotypes suggest a poor prognosis.