Evaluation of bone marrow specimens with acute myelogenous leukemia for CD34, CD15, CD117, and myeloperoxidase
C H Dunphy1, J M Polski, H L Evans
1Division of Hematopathology, Department of Pathology, St Louis University Health Sciences Center, St Louis, MO, USA. cdunphy@unch.unc.edu
Insights
Flow cytometry (FC) and immunohistochemistry (IH) reliably detect CD34 in acute myelogenous leukemia (AML). FC is superior for CD15 and CD117 detection, while IH excels for myeloperoxidase (MPO) analysis in AML.
Area of Science:
- Hematology
- Oncology
- Immunophenotyping
Background:
- Bone marrow (BM) immunophenotyping in acute myelogenous leukemia (AML) utilizes flow cytometry (FC) and immunohistochemistry (IH).
- Key markers like CD34, CD15, and CD117 are assessed by both FC and IH.
- Myeloperoxidase (MPO) can be evaluated by enzyme cytochemistry (EC) or IH.
Purpose of the Study:
- To compare the reliability of FC, EC, and IH techniques for immunophenotyping AML.
- To assess the diagnostic accuracy of CD34, CD15, CD117, and MPO detection across different methods.
Main Methods:
- Analysis of 29 AML specimens previously characterized by FC and EC.
- Immunohistochemical staining of BM core biopsies and clots for CD34, CD15, CD117, and MPO.
- Comparison of IH results with prior FC and EC findings.
Main Results:
- CD34 detection showed similar sensitivity between FC and IH.
- FC demonstrated higher sensitivity for CD15 and CD117 compared to IH.
- IH exhibited greater sensitivity for MPO detection than EC.
- CD15 expression correlated with monocytic components in AML.
- MPO reactivity by IH was noted in FAB M0 subtype AMLs.
Conclusions:
- CD34 is reliably detected by both FC and IH.
- FC is the preferred method for CD15 and CD117 detection in AML.
- IH is the superior technique for MPO analysis in AML specimens.
Context:
Immunophenotyping of bone marrow (BM) specimens with acute myelogenous leukemia (AML) may be performed by flow cytometric (FC) or immunohistochemical (IH) techniques. Some markers (CD34, CD15, and CD117) are available for both techniques. Myeloperoxidase (MPO) analysis may be performed by enzyme cytochemical (EC) or IH techniques.
Objective:
To determine the reliability of these markers and MPO by these techniques, we designed a study to compare the results of analyses of these markers and MPO by FC (CD34, CD15, and CD117), EC (MPO), and IH (CD34, CD15, CD117, and MPO) techniques.
Materials And Methods:
Twenty-nine AMLs formed the basis of the study. These AMLs all had been immunophenotyped previously by FC analysis; 27 also had had EC analysis performed. Of the AMLs, 29 had BM core biopsies and 26 had BM clots that could be evaluated. The paraffin blocks of the 29 BM core biopsies and 26 BM clots were stained for CD34, CD117, MPO, and CD15. These results were compared with results by FC analysis (CD34, CD15, and CD117) and EC analysis (MPO).
Results:
Immunodetection of CD34 expression in AML had a similar sensitivity by FC and IH techniques. Immunodetection of CD15 and CD117 had a higher sensitivity by FC analysis than by IH analysis. Detection of MPO by IH analysis was more sensitive than by EC analysis. There was no correlation of French-American-British (FAB) subtype of AML with CD34 or CD117 expression. Expression of CD15 was associated with AMLs with a monocytic component. Myeloperoxidase reactivity by IH analysis was observed in AMLs originally FAB subtyped as M0.
Conclusions:
CD34 can be equally detected by FC and IH techniques. CD15 and CD117 are better detected by FC analysis and MPO is better detected by IH analysis.
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