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Flowcytometric immunophenotypic profile of acute leukemia: mansoura experience
Dalia A Salem1, Sherin M Abd El-Aziz
1Clinical Pathology Department, Hematology Unit, Mansoura Faculty of Medicine, Mansoura, Egypt.
Insights
This study evaluated immune markers for diagnosing acute leukemia (AL) in Egyptian patients. Key markers like CD34 and HLA-DR effectively differentiate subtypes, aiding accurate classification and treatment strategies.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Acute leukemia (AL) diagnosis relies on antigen expression patterns.
- Immunophenotyping is crucial for AL classification and treatment guidance.
Purpose of the Study:
- Evaluate diagnostic utility of immune markers for AL immunophenotyping.
- Define optimal immune markers for AL diagnosis and classification.
- Determine AL subtype frequencies and antigen profiles in Egyptian patients.
Main Methods:
- Retrospective analysis of immunophenotypic data from 164 de novo AL patients.
- Utilized flow cytometry for antigen expression analysis.
- Applied standard antibody panels for immunophenotyping.
Main Results:
- 68.9% AML, 31.1% ALL observed. AML-M4/5 was the most common AML subtype (34.5%).
- Combined HLA-DR and CD34 distinguished APL from non-APL AML.
- cCD79a/CD19 for B-ALL, cCD3/CD7/CD5 for T-ALL showed high sensitivity.
Conclusions:
- Employed antibody panels are adequate for AL diagnosis and classification.
- Flow cytometry is valuable for identifying AML-M0 and differentiating APL.
- Findings comparable to international data, with notable differences in AML-M4/5 predominance and APL frequency.
Abstract:
Acute leukemia (AL) displays characteristic patterns of antigen expression, which facilitate their identification and proper classification. The purpose of this study is to evaluate the diagnostic usefulness of commonly used immune-markers for immunophenotyping of AL and to define the best immune-markers to be used for proper diagnosis and classification of AL. Besides, to recognize the frequency of different AL subtypes and the antigen expression profile in our Egyptian patients. We retrospectively analyzed the immunophenotypic data of 164 de novo AL patients from our institution during 2009 and 2010. Among these patients, 68.9% were classified as acute myeloblastic leukemia (AML) while 31.1% classified as acute lymphoblastic leukemia (ALL). The commonest FAB subtype in AML group was AML-M4/5 (34.5%) which may differ from most published data. As regard ALL, there were 74.5% with B-ALL and 25.5% with T-ALL. It was found that combined use of HLADR and CD34 was much more helpful in distinguishing APL from non-APL AML than either of these antigens alone. It was found that cCD79a and CD19 were the most sensitive marker for B-ALL while cCD3, CD7 and CD5 were the most sensitive antigens for T-ALL. Our analysis of AL phenotypes proved that employed antibody panels are adequate for proper diagnosis and classification of AL. Flowcytometry was found to be especially useful in the identification of AML-M0 and differentiation of APL from non-APL AML. Immunophenotyping results and FAB classification of our AL patients were comparable to internationally published studies apart from predominance of AML-M4/5 and more frequent APL.
