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Routine immunophenotyping in acute leukemia: Role in lineage assignment and reassignment.

Misbah Qadir1, Maurice Barcos, Carleton C Stewart

  • 1Leukemia Section, Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.

Cytometry. Part B, Clinical Cytometry
|June 2, 2006
PubMed
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Immunophenotyping by multiparameter flow cytometry is crucial for diagnosing acute leukemia. This method clarified lineage in cases where morphology and cytochemistry were inconclusive, improving diagnostic accuracy.

Area of Science:

  • Hematology
  • Oncology
  • Immunology

Background:

  • Acute leukemia diagnosis traditionally relies on morphology and cytochemistry.
  • Limitations exist in these methods for definitively establishing cell lineage.
  • Multiparameter flow cytometry immunophenotyping offers a more detailed cellular analysis.

Purpose of the Study:

  • To evaluate the utility of immunophenotyping in diagnosing acute leukemia.
  • To assess its role in cases with ambiguous lineage determination by conventional methods.
  • To support or refute the routine inclusion of immunophenotyping in diagnostic workflows.

Main Methods:

  • Retrospective analysis of 646 acute leukemia cases.
  • Comparison of lineage assignment by morphology/cytochemistry versus immunophenotyping.

Related Experiment Videos

  • Utilized multiparameter flow cytometry for immunophenotyping.

    • Main Results:

    • Morphology and cytochemistry were insufficient for lineage determination in 34 cases (5%).
    • Immunophenotyping resolved lineage in these 34 cases, identifying myeloid, undifferentiated, and lymphoid subtypes.
    • Immunophenotyping altered the initial lineage assignment in 11 cases (2%), including 8 lymphoid-to-myeloid and 3 myeloid-to-lymphoid shifts.

    Conclusions:

    • Immunophenotyping is essential for accurate acute leukemia diagnosis.
    • It resolves lineage ambiguities and corrects misclassifications from morphology/cytochemistry alone.
    • Routine inclusion of limited immunophenotyping is recommended for acute leukemia evaluation.