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Flow Cytometry to Estimate Leukemia Stem Cells in Primary Acute Myeloid Leukemia and in Patient-derived-xenografts, at Diagnosis and Follow Up
Published on: March 26, 2018
Immunophenotypic characterization of acute lymphoblastic leukemia in a flowcytometry reference centre in Sri Lanka
Manujasri Wimalachandra1, Manurie Prabashika, Medhavini Dissanayake
1Faculty of Medicine, University of Colombo, Sri Lanka,manuwimala@gmail.com.
Insights
This study details the immunophenotypic features of acute lymphoblastic leukemia (ALL) in Sri Lankan children and adults. Findings align with global data, aiding in accurate diagnosis and treatment strategies for ALL.
Area of Science:
- Hematology
- Immunology
- Pediatric Oncology
Background:
- Acute lymphoblastic leukemia (ALL) is a heterogeneous disease requiring precise immunophenotypic characterization for diagnosis, treatment, and prognosis.
- Understanding the immunophenotypic landscape of ALL is crucial for effective patient management.
Purpose of the Study:
- To characterize the immunophenotypic and laboratory features of ALL in a Sri Lankan cohort.
- To compare these features with international findings for ALL.
Main Methods:
- Retrospective review of 229 patient records referred for flow cytometry analysis.
- Data collected from August 2009 to October 2013 at Asiri Hospital, Sri Lanka.
Main Results:
- 80% of cases were B-lymphoblastic leukemia (B-ALL) and 20% T-lymphoblastic leukemia (T-ALL).
- Peak incidence in children was 2-6 years for B-ALL and 3-6 years for T-ALL.
- Immunophenotypic profiles, including CD10, CD3, and nTdT expression, and myeloid antigen presence, were detailed for B-ALL and T-ALL subtypes.
Conclusions:
- This study provides the first immunophenotype-based description of ALL in Sri Lanka.
- The observed age, sex distribution, ALL subtypes, and immunophenotypic profiles are consistent with previous international studies.
Background:
Acute lymphoblastic leukemia (ALL), is a biologically heterogeneous disease where diagnosis, treatment and prognosis is heavily dependent on the correct characterization of the immunophenotype of each case.
Objectives:
To describe the immunophenotypic and laboratory features of a cohort of Sri Lankan children and adults with ALL and to compare them with those reported in other series.
Methods:
Records of 229 patients who were suspected of having acute leukaemia and referred for flow cytometry to the Asiri Hospital Sri Lanka, between August 2009 and October 2013 were reviewed. Referrals were from across the country including the National Cancer Institute.
Results:
Sixty seven percent were children below 12 years of age. 80% had B-lymphoblastic leukaemia (B-ALL), 20% T- lymphoblastic leukaemia (T-ALL). In children, the peak age of diagnosis was between 2-6 years in B-ALL (61%) and 3-6 years (43.7%) in T-ALL. Incidence was commoner in males in all age groups and subtypes except in the adult B ALL group where the incidence was equal. Ninety three percent of paediatric B-ALL and 67% adult B-ALL were CD10 positive common ALL. In T-ALL cytoplasmic expression of CD3 was 100%. nTdT was the most commonly expressed immature marker, in B-ALL - 91% and in T-ALL- 69%. At least one myeloid antigen was present in 34% of B-ALL cases and 60% of T-ALL cases.
Conclusions:
This study represents the first immunophenotype based description of ALL in Sri Lanka. Age, sex distribution, ALL subtypes and the immunophenotypic profile of each subtype mirrored those of previous studies.
