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Diagnostic application of monoclonal antibody KB90 (CD11c) in acute myeloid leukaemia
P S Master1, S J Richards, J Kendall
1Department of Haematology, Cookridge Hospital, Leeds, UK.
Insights
CD11c expression on leukaemic cells can help distinguish monocytic from non-monocytic acute myeloid leukaemia (AML) subtypes. This marker shows promise, especially when compared with traditional monocytic differentiation markers.
Area of Science:
- Immunology
- Hematology
- Oncology
Background:
- Accurate subtyping of acute myeloid leukaemia (AML) is crucial for effective treatment strategies.
- Distinguishing monocytic AML subtypes (AMML-M4, AMoL-M5) from non-monocytic subtypes (M1, M2, M3) can be challenging.
- CD11c is a membrane protein whose expression patterns are being investigated for diagnostic utility in leukaemias.
Purpose of the Study:
- To evaluate membrane CD11c expression as a diagnostic marker for differentiating monocytic AML subtypes.
- To compare the efficacy of CD11c detection with established markers of monocytic differentiation, such as CD14 and alpha-naphthyl acetate esterase (ANAE).
- To assess the reliability of the immunorosetting technique for CD11c detection in leukaemic cells.
Main Methods:
- Indirect immunorosetting was employed to examine CD11c membrane expression in 75 cases of acute leukaemia (60 AML, 15 ALL).
- AML cases were classified into monocytic (AMML-M4, AMoL-M5) and non-monocytic (M1, M2, M3) subtypes.
- CD11c expression was compared with cytoplasmic ANAE and membrane CD14 expression.
Main Results:
- Non-monocytic AML subtypes (n=33) were predominantly CD11c- (less than 30% positive cells).
- Most AMML-M4 (13/14) and AMoL-M5 (14/15) cases were CD11c+ (greater than 30% positive cells).
- CD11c expression was observed in AMML-M4 cases irrespective of CD14 or ANAE status, and AMoL-M5 cases showed varied CD11c and CD14 expression profiles. All lymphoblastic leukaemia (ALL) cases showed minimal CD11c expression (<5%).
Conclusions:
- Membrane CD11c expression is a valuable marker for distinguishing monocytic AML subtypes from non-monocytic AML.
- CD11c detection by immunorosetting is a sensitive and effective method, comparable to flow cytometry.
- CD11c expression provides complementary information to CD14 and ANAE, aiding in the phenotypic characterization of leukaemic cells.
Abstract:
The expression of membrane CD11c by leukaemic blast cells was examined (indirect immunorosetting) in 75 cases of acute leukaemia (myeloid, n = 60; lymphoid, n = 15) and evaluated as a potential marker for the diagnostic discrimination between monocytic (AMML-M4 and AMoL-M5) and non-monocytic (M1, M2 and M3) AML subtypes. Preliminary studies of normal bone marrow cells indicated that CD11c expression was not restricted to cells of monocytic lineage but was also present, with apparent lower density, on significant proportions of mature and immature granulocytes. Examination of acute myeloid leukaemia (AML) subtypes revealed that the non-monocytic leukaemias (n = 33) were CD11c-, defined as less than 30% positive cells, whereas all but one of the AMML-M4 (n = 13) and AMoL-M5 (n = 14) cases were CD11c+. All 15 cases of lymphoblastic leukaemia (ALL) showed less than 5% CD11c+ blasts. Membrane CD11c expression was also compared to the more widely used markers of monocytic differentiation; cytoplasmic alpha-naphthyl acetate esterase (ANAE) and membrane CD14 expression. This analysis showed that all 13 AMML-M4 leukaemias studied, including seven cases that were CD14- and eight that were ANAE-, were CD11c+. In addition, the AMoL-M5 cases (all of which were ANAE+) could be phenotypically subdivided into CD11c+ CD14+ (n = 9), CD11c+ CD14- (n = 4) and CD11c- CD14- (n = 1) subgroups. The study also confirmed that the discriminitive ability and sensitivity of the immunorosetting procedure for the detection of membrane CD11c compared favourably to immunofluorescent staining intensities as measured by flow cytometry.
