Immunophenotypic Heterogeneity and Clonal Sweep in Acute Myeloid Leukemia Revealed by Flow Cytometry: A Case Series...

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Clonal evolution in acute myeloid leukemia (AML) is typically defined by mutations and cytogenetic changes.
• Limited research has explored immunophenotypic heterogeneity via flow cytometry and its impact on AML progression.

Purpose of the Study:

• To investigate immunophenotypic heterogeneity in AML using flow cytometry.
• To identify phenotypic subclones and assess their relationship with disease progression and survival.

Main Methods:

• Flow cytometry immunophenotyping was performed on 24 AML patients.
• Phenotypic profiles were correlated with molecular alterations detected by next-generation sequencing.

Main Results:

• Flow cytometry identified more complex clonal heterogeneity than molecular profiling at diagnosis and relapse.
• Small phenotypic subclones, undetectable by molecular methods, were identified and some expanded over time.
• The presence of small clones correlated with shorter progression-free and overall survival.

Conclusions:

• Flow cytometric clonal heterogeneity, particularly small clones (2-30% antigen expression), offers a novel prognostic factor in AML.
• Integrating immunophenotyping with molecular data can enhance risk stratification and personalized monitoring for AML patients.