Immunophenotypic modulation in pediatric B lymphoblastic leukemia and its implications in MRD detection.
Ramalingam Thulasi Raman1, Muthu Anurekha1, Vaidhyanathan Lakshman1
1Department of Hematology, Apollo Cancer Centre, Chennai, India.
Leukemia & Lymphoma
|April 14, 2020
Summary
Antigenic changes in leukemia cells can affect minimal residual disease (MRD) detection in B cell precursor acute lymphoblastic leukemia (BCP-ALL). Adjusting antibody panels improves MRD quantification accuracy.
Area of Science:
- Hematology
- Immunology
- Pediatric Oncology
Background:
- Minimal/Measurable residual disease (MRD) is a key prognostic factor in B cell precursor acute lymphoblastic leukemia (BCP-ALL).
- Antigenic expression on leukemia cells can change after chemotherapy, potentially leading to inaccurate MRD quantification by flow cytometry.
Purpose of the Study:
- To investigate immunophenotypic modulation of nine antigens in residual leukemia cells from BCP-ALL children post-induction.
- To assess the impact of these changes on MRD detection accuracy.
Main Methods:
- Analysis of immunophenotypic modulation of nine antigens in residual leukemic cells from 31 BCP-ALL children.
- Comparison of antigen expression at postinduction MRD assessment with baseline diagnostic data.
Main Results:
- Significant downmodulation of CD10, CD38, CD58, and CD81 observed.
- Significant upmodulation of CD19 and CD45 observed.
- MRD-positive cases showed loss or gain of leukemia-associated immunophenotypes (LAIP).
Conclusions:
- Immunophenotypic modulation of antigens is common in BCP-ALL post-chemotherapy.
- Current antibody panels may require adjustments, including novel markers, to enhance MRD detection sensitivity.
- Accurate MRD assessment is crucial for BCP-ALL prognosis.
