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[Immunophenotyping characteristics of adult patients with acute lymphoblastic leukemia in different ages]
Jie Ma1, Yan-Fang Liu, Sheng-Mei Chen
1Department of Hematology, Zhengzhou University First Affiliated Hospital, Zhengzhou 450052, Henan Province, China.
Insights
Immunophenotyping reveals age-related differences in adult T-cell acute lymphoblastic leukemia (T-ALL), with aberrant phenotypes in older adults indicating a poorer prognosis. B-cell acute lymphoblastic leukemia (B-ALL) showed no significant age-associated immunophenotypic changes.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Acute lymphoblastic leukemia (ALL) is a heterogeneous hematologic malignancy.
- Immunophenotyping is crucial for classifying ALL subtypes and guiding treatment.
- Age is a significant factor influencing ALL presentation and outcomes.
Purpose of the Study:
- To investigate age-related immunophenotypic variations in adult acute lymphoblastic leukemia (ALL).
- To compare immunophenotypic profiles of T-cell ALL (T-ALL) and B-cell ALL (B-ALL) across different adult age groups.
Main Methods:
- Flow cytometry was used for immunophenotyping of 260 adult ALL patients.
- Monoclonal antibodies and CD45/SSC gating were employed for analysis.
- Patients were stratified into adolescent (14-18 years), young adult (19-35 years), and older adult (>35 years) groups.
Main Results:
- T-ALL cases showed decreased CD2 expression with aging, while CD34 and HLA-DR expression increased.
- Older adult T-ALL patients exhibited significant differences in HLA-DR, myeloid antigen (MyAg), and CD13 expression compared to younger groups.
- B-ALL cases demonstrated no significant age-associated immunophenotypic variations, with high CD19 and HLA-DR positivity across all age groups.
Conclusions:
- Adult T-ALL immunophenotypes are heterogeneous and age-dependent, with aberrant phenotypes correlating with poorer prognosis in older adults (>35 years).
- Age does not significantly impact immunophenotype in adult B-ALL.
- Immunophenotypic analysis aids in understanding age-specific ALL characteristics.
Abstract:
The purpose of this study was to investigate the immunophenotyping characteristics of adult acute lymphoblastic leukemia (ALL) patients in groups of different ages. Immunophenotyping was performed in 260 ALL patients by flow cytometry using a panel of monoclonal antibodies and CD45/SSC gating. The results indicated that (1) all the 82 cases of T-cell acute lymphoblastic leukemia (T-ALL) expressed CD7 (100%) while the positive rate of CD2 remarkably decreased with aging. The positive rate of CD2 in patients aged 14 to 18 years (adolescents) was 91.67%, which is significantly higher than that in cases aged 19 to 35 years (young adults) and > 35 years (older adults) (65.71% and 43.48% respectively, p < 0.05); the positive rate of CD34 and HLA-DR increased with aging, there was significant difference of the HLA-DR expression between the older adults group (39.13%) and the other two groups (4.17% in adolescents and 11.43% in young adults respectively (p < 0.05). Moreover, there were significant differences of the myeloid antigen (MyAg) and CD13 expression between the older adults and younger adults (p < 0.05). (2) As to adult B-cell acute lymphoblastic leukemia (B-ALL), the positive rates of CD19 and HLA-DR in 178 cases were 100%; the positive rate of CD33 in young adults was significant higher than that in adolescents (p < 0.05), the differences of the other marker expressions failed to reach statistical significance in adult B-ALL patients. It is concluded that the immunophenotypes of adult T-ALL are evidently heterogeneous in different ages, and expression with more aberrant phenotypes indicates poor prognostic significance in patients older than 35 years. There is no significant association of immunophenotypes with ages among different age groups of adult B-ALL.
