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Published on: March 26, 2018
Immunophenotyping of acute lymphoblastic leukemia in pediatric patients by three-color flow cytometric analysis
P Tiensiwakul1, T Lertlum, I Nuchprayoon
1Department of Clinical Microscopy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
Insights
Immunophenotyping using flow cytometry classified childhood acute lymphoblastic leukemia (ALL) into common ALL, B-ALL, and T-ALL. This classification aids in understanding leukemia subtypes and guiding prognosis and treatment strategies.
Area of Science:
- Hematology
- Pediatric Oncology
- Immunology
Background:
- Acute lymphoblastic leukemia (ALL) is a significant pediatric cancer.
- Accurate immunophenotyping is crucial for classifying ALL subtypes.
- Understanding CD marker expression aids in diagnosis and prognosis.
Purpose of the Study:
- To perform immunophenotyping of pediatric ALL cases using three-color flow cytometry.
- To classify ALL subtypes (common ALL, B-ALL, T-ALL) based on CD marker expression.
- To analyze the frequency and significance of aberrant marker expression and relapse patterns.
Main Methods:
- Three-color flow cytometry was used for immunophenotyping.
- 38 pediatric patients with ALL were analyzed.
- CD marker expression patterns were evaluated for different ALL subtypes.
Main Results:
- Common ALL (c-ALL) comprised 65.8%, B-ALL 15.8%, and T-ALL 18.4% of cases.
- Relapse rates were highest in B-ALL (3/6 cases).
- Specific CD marker profiles were identified for c-ALL, B-ALL, and T-ALL, with varying frequencies of myeloid aberrant expressions.
Conclusions:
- Immunophenotyping is a valuable tool for classifying pediatric ALL.
- Classification into c-ALL, B-ALL, and T-ALL is useful for prognosis and treatment planning.
- Analysis of CD markers and aberrant expression provides insights into ALL biology and patient outcomes.
Abstract:
Immunophenotyping of acute lymphoblastic leukemia (ALL) in children using three-color flow cytometry was carried out at Chulalongkorn Hospital, Bangkok, Thailand. Of 38 patients with acute lymphoblastic leukemia, 65.8% were identified as common ALL, 15.8% were B-ALL, and 18.4% were T-ALL. Of these 38 cases, there were 4 cases of infantile leukemia. Relapsed cases of leukemia were found most in B-ALL up to 3 out of 6 cases and to a lesser extent in T-ALL (1 of 7 cases) and c-ALL (1 of 25 cases). Our data showed the CD markers expression for common ALL (c-ALL) were CD19+/10+ (100%), CD20+ (24%), CD22+ (100%), HLA-DR+ (70.1%), and CD34+ (58.8%). CD markers expression for B-ALL were CD19+ (100%), CD20+ (33.3%), CD22+ (80%), and HLA-DR+ (80%). CD markers expression for T-ALL were CD3+ (42.9%), CD5+ (100%), CD7+ (85.7%). Myeloid aberrant expressions were found in c-ALL (25-37.5%), B-ALL (20%), and T-ALL (14.3%). The significance of the aberration is discussed. The immunophenotyping classification of ALL as c-ALL, B-ALL, and T-ALL is useful in prognosis and treatment.
