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Rapid immunocytochemical analysis of acute leukemias
R D Hammer1, R D Collins, S Ebrahimi
1Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee 37232.
Insights
A rapid 1-hour immunocytochemical technique accurately phenotyped acute leukemias, matching standard methods. This method offers an efficient alternative for diagnosing acute lymphocytic leukemia (ALL) and acute nonlymphocytic leukemia (ANLL).
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Immunophenotypic analysis is crucial for acute leukemia diagnosis.
- Traditional methods like flow cytometry can be time-consuming.
Purpose of the Study:
- To evaluate a rapid 1-hour immunocytochemical procedure as an alternative for acute leukemia phenotyping.
- To compare the accuracy of the rapid method with standard diagnostic techniques.
Main Methods:
- A 1-hour alkaline phosphatase-labeled streptavidin-biotin immunocytochemical procedure was used.
- Seventeen acute leukemia cases (10 ALL, 7 ANLL) were phenotyped.
- Results were compared with standard cytochemical and flow cytometric analyses.
Main Results:
- The rapid immunocytochemical method achieved diagnostic accuracy comparable to standard methods in all 17 cases.
- Specific markers for B-cell ALL (CD19, CD22), T-cell ALL (CD1-3, CD7), and ANLL (CD15, CD13, CD33, myeloperoxidase) were identified.
- Unexpected reactivity of myeloid markers (CD15, MPO-7) in some ALL cases was confirmed.
Conclusions:
- The 1-hour immunocytochemical technique provides an easy and accurate method for acute leukemia phenotyping.
- This rapid approach allows for permanent slide storage and coordinated evaluation of morphology and immunophenotype.
- The method correlates highly with flow cytometry and cytochemical results, offering a valuable diagnostic tool.
Abstract:
Immunophenotypic analysis of acute leukemias is time consuming and often requires flow cytometric analysis. A 1-hour alkaline phosphatase-labeled streptavidin-biotin immunocytochemical procedure was evaluated as an alternative. Seventeen cases of acute leukemia, including 10 acute lymphocytic (ALL) and 7 acute nonlymphocytic, were phenotyped by the rapid immunocytochemical procedure and the results were compared with standard analyses. In all 17 cases, the diagnoses made using standard cytochemical and immunologic methods were the same as obtained in blinded reviews by rapid immunocytochemical analysis. Nine cases of precursor B-cell ALL were positive for CD19 and/or CD22. Five CD19 + cases of ALL reacted with anti-myeloperoxidase, with one case also positive for CD15. CD15 positivity was confirmed on repeated study as well as with plastic section immunoperoxidase staining. Nine cases of ALL were positive for CD10 and eight were positive for terminal deoxynucleotidyl transferase. One case of ALL marked as T-cell ALL with CD1, CD2, CD3, and CD7. All cases of acute nonlymphocytic leukemia were positive for CD15, CD13, and/or CD33; anti-myeloperoxidase was positive in all but one case of monocytic leukemia. All cases of acute nonlymphocytic leukemia were negative for CD10 and one was positive for terminal deoxynucleotidyl transferase. Acute leukemias apparently may be phenotyped easily and accurately in 1 hour with this immunocytochemical technique, and slides may be stored permanently for review. There was in these 17 cases high correlation of the diagnoses with standard flow cytometric and cytochemical results. This rapid method allows a coordinated evaluation of morphologic features and immunophenotype; the latter features facilitated confirmation of unexpected reactivity of myeloid markers CD15 and MPO-7 in some cases of ALL.