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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
Aberrant expression of myeloid antigens in patients of acute lymphoblastic leukaemia
Alina Jawad1, Saleem Ahmed Khan2, Nasir Uddin3
1Department of Haematology and Pathology, Army Medical College, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan.
Insights
Aberrant myeloid marker expression in acute lymphoblastic leukemia (ALL) is common and impacts prognosis. Documenting these myeloid markers during immunophenotyping is crucial for accurate ALL diagnosis and patient management.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Acute lymphoblastic leukemia (ALL) is a heterogeneous hematologic malignancy.
- Immunophenotyping is critical for ALL diagnosis and classification.
- Aberrant antigen expression can influence ALL prognosis.
Purpose of the Study:
- To investigate the immunophenotypic profile of newly diagnosed ALL patients.
- To assess the aberrant expression of myeloid antigens in ALL.
- To determine the clinical significance of aberrant myeloid marker expression in ALL.
Main Methods:
- A descriptive cross-sectional study involving 73 newly diagnosed ALL patients.
- Morphological assessment via CBC, cytochemical stains, and bone marrow examination.
- Flow cytometry for immunophenotyping of peripheral blood and bone marrow samples.
Main Results:
- Commonly expressed markers included weak CD45, TdT, CD19, CD10, and HLA-DR.
- Aberrant myeloid antigen expression (CD13, CD33) was observed in 17.8% of cases.
- Weak CD45 expression was nearly universal across ALL subtypes.
Conclusions:
- Aberrant myeloid marker expression in ALL has prognostic implications.
- Immunophenotyping should include assessment for aberrant myeloid markers in ALL.
- Documentation of aberrant myeloid markers aids in lineage assignment and patient management.
Objective:
To determine the immunophenotypic pattern and aberrant expression of myeloid antigens in newly diagnosed patients of acute lymphoblastic leukaemia(ALL).
Methods:
This descriptive cross-sectional study was carried out in Haematology / Pathology department, Army Medical College, National University of Medical Sciences (NUMS) in collaboration with Immunology and Haematology departments of Armed Forces Institute of Pathology (AFIP), Rawalpindi from 1st January, 2019 to 31st December, 2019. Seventy-three (73) recently diagnosed patients of Acute Lymphoblastic leukaemia of all age groups and both genders were included in the study. A proforma was used to note demographic data. CBC, cytochemical stains and bone marrow examinations were carried out and assessed for morphology and percentage of blasts using a microscope. Flow cytometry was used to perform immunophenotyping on samples of peripheral blood and bone marrow, using a standard panel.
Results:
The most commonly expressed markers were weak CD45, TdT, CD19, CD10 and HLA-DR. Weak CD45 was present in almost all blast cells and there was no remarkable difference in its positivity among various subtypes of ALL. Myeloid expression was observed in 13 (17.8%) cases. CD13 and CD33 were aberrantly expressed in 11 and 12.3 of all cases of ALL respectively.
Conclusions:
Expression of aberrant myeloid CD markers in acute lymphocytic leukaemia has prognostic significance and should be documented during lineage assignment of acute leukaemias while performing immunophenotyping.
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